Center for Health Information & Decision Systems  

CHIDS NEWSLETTER

Volume 5 Issue 1                                                                              Fall 2011

In This Issue

The Information Value of Online Physician Ratings

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CHIDS on Maryland ONC HIE Challenge Grant Team

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HIE Gets a New Evaluation Framework

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Development of a Model EHR Format for Children

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Personal Health Records and Secure Messaging for Military Personnel Pilot Program

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UMD Health IT Seed Grant Program

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Public Health Collaboratory for Training and Learning

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2nd Annual Workshop on Health IT and Economics (WHITE)

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University of Maryland Fall Health IT Summit

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CHIDS Co-Hosts 11th Annual CIO Forum

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COE HITR Lunch Seminar Series (Ongoing)

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Newest Member of the CHIDS Team:
Emily McPherson

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Featured Partner: CareFirst

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Featured 2010-2011 Student Fellow:
Helen Culbertson

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CHIDS Director Gains AHRQ Appointment and is Named Distinguished Scholar-Teacher

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CHIDS Student Fellows

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Letter from the Director

With your continued support we have made significant strides in our mission to improve quality and reduce cost in the healthcare ecosystem and launched a number of new projects. For example, recognizing that as with other sectors of the economy the world of healthcare is going to be transformed by social media, our team is investigating how social media can help healthcare finance organizations meet objectives related to cost and patient and provider engagement. We also have initiated a new Health Information Exchange (HIE) project with the Maryland HIE (the
Chesapeake Regional Information System for Our Patients or CRISP), which examines how electronic health information exchange can improve care coordination and safety across acute care and long-term care facilities. Additionally, the conclusion of our study of the DC HIE (the DC Regional Health Information Organization or RHIO) resulted in an evaluation framework for HIE efforts that can serve as a model as the nation moves forward with the electronic exchange of health information.

CHIDS is leading two efforts to facilitate a multidisciplinary community of health researchers.
1.) Our annual Workshop on Health IT and Economics (WHITE), now in its second year, will be held in Washington DC on October 21-22. The Agency for Healthcare Research and Quality (AHRQ), acknowledging the value of such a venue, has recently awarded CHIDS a three-year co
nvening grant for WHITE.
2.) Together with the UMD School of Public Health, we are leading a cross-campus effort to pool capabilities across academic disciplines at our College Park and Baltimore Campuses. The newly established Center of Excellence in Health IT Research (COEHITR) serves as the focal organization to accelerate transformation efforts.

A final area that I will draw your attention to is one that affects each of us in a deep and personal way: how can we progress toward becoming a more patient-centric healthcare system where patients are engaged and focal players in managing their healthcare needs and well-being? We have several research projects in this area, e.g., a longitudinal study of the US Air Force's implementation of personal health records and secure patient-provider messaging to understand the effects of these interventions on health outcomes and healthcare utilization.

As always, the success of our efforts is constructed on a foundation of partnerships. I invite you to continue the dialog, challenge our assumptions, ask difficult questions, and offer your insights on our shared mission. Join us!

Ritu Agarwal
Founder and Director of CHIDS
Professor and Dean's Chair of Information Systems

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The Information Value of Online Physician Ratings

CHIDS Fellow Brad Greenwood presented findings from his Working Paper "The Information Value of Online Physician Ratings" at INFORMS Healthcare 2011 in Montreal, Quebec. The paper examines the usefulness and potential biases among user ratings on physicians on the Internet.

Working Paper: http://bit.ly/InfoValueofDoctorRatings
 
Podcast: http://bit.ly/InfoValuePodcast

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CHIDS on Maryland ONC HIE Challenge Grant Team

A team of CHIDS researchers including those from the University of Maryland, College Park and the School of Medicine at the University of Maryland, Baltimore have been awarded Office of the National Coordinator for Health IT (ONC) funds to develop and evaluate innovations designed to improve healthcare coordination, convenience and safety for patients.

ONC has awarded $16 million in Health Information Exchange (HIE) Challenge Grants nationwide to encourage innovations that facilitate the secure sharing and "Meaningful Use" of patient health information.

Ritu Agarwal and Kenyon Crowley of the Robert H. Smith School of Business and Ram Miller of the School of Medicine will work with the Chesapeake Regional Health Information Systems for Patients (CRISP), the Maryland Health Care Commission, Erickson Living, Lorien Health Systems, Audacious Inquiry and other partners to study the impact of HIE on patient care in post-hospital and long-term care environments. The team of researchers is part of CHIDS and the multi-campus University of Maryland Center of Excellence in Health Information Technology Research (COE HITR), an organization which seeks to accelerate the transformation of healthcare through science-based solutions.

"We are thrilled to work with these partners to drive innovation and help evaluate, improve and share new solutions to improve care transitions" says Mr. Crowley. "The strain on patients, their families and the healthcare system from missing or incomplete information is huge and can be deadly. We hope what we learn in Maryland can be a model for improvement nationwide." According to one study, 22 percent of transfers from hospitals to nursing homes and other post-hospital environments were not accompanied with a formal summary of patient information.

CHIDS research will involve a series of quantitative and qualitative techniques to determine the social, technical and other factors that affect the successful adoption and use of HIE tools to improve care transitions between acute and long-term care environments.

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HIE Gets a New Evaluation Framework

CHIDS has developed a health information exchange (HIE) Evaluation Framework to help states and other HIE operators create self-sustaining and effective networks for the exchange of electronic health information. Co-authored by CHIDS Director Ritu Agarwal, Sunil Mithas, Smith School of Business Associate Professor, Kenyon Crowley, CHIDS Associate Director, and Jiban Khuntia, Smith School of Business PhD candidate, the Framework provides an assessment methodology for Regional Health Information Organizations (RHIOs). RHIOs are evaluated on five key performance components:

1.) Value creation and sustainability - the value generated by the HIE for society and other relevant stakeholders, and whether the business model and revenue stream offset operational costs.
2.) Governance - policies, structural mechanisms and decision-making processes that guide the strategic, tactical and operational activities of the enterprise
3.) Technology - the quality of the RHIO or HIE infrastructure, measured by cost-effectiveness, adherence to standards and usability. This also includes change management and other activities necessary for adopting the technology.
4.) Community engagement - success in engaging all concerned parties
5.) Public trust - privacy practices and policies crafted and the degree of public trust in the enterprise.

The Framework and associated recommendations encompass information and documents provided by an environmental scan of HIE efforts across the nation, best practices from the literature, benchmarking with leading HIEs, and comments from key public and private stakeholders of the DC RHIO. Recently used to evaluate the DC RHIO (Washington's primary HIE), the Framework ranked the RHIO among the top 20 percent of HIEs as a fully operational exchange, but also offered recommendations on how to make the organization sustainable through operating revenue. Although the DC RHIO has made progress in most dimensions of the HIE Assessment Model and has reached operational status (transmitting data that is being used by healthcare stakeholders), it is noted that much work remains to be done to reach a sustainable state.

Earlier this year Kenyon Crowley presented the Framework at the Healthcare Information and Management Systems Society (HIMSS) annual conference, HIMSS11. Key points from his presentation included: performance criteria for HIE sustainability, how to apply the Evaluation Framework to improve strategic planning for HIE initiatives, ancillary activities that drive successful HIE operations, and how the DC RHIO is using the framework to support its HIE activities. Access the complete report at http://bit.ly/CHIDS_HIE_Evaluation
 

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Development of a Model EHR Format for Children

EHRs when implemented well, are comprehensive systems that support the health record-related needs of clinicians and patients. Unfortunately, for a variety of reasons, EHR systems often fail to optimally support the idiosyncrasies of children's healthcare. This project aims to develop a Model EHR Format for children that includes requirements for: a minimum set of data elements; applicable data standards; usability, functionality, and interoperability. It will demonstrate that the format can be used and packaged in a way that facilitates broad incorporation into EHR systems. This will facilitate care coordination and management throughout the children's health "ecosystem."

CHIDS is working with a broad partnership led by Westat and supported by AHRQ and CMS that includes the American Academy of Pediatrics, American Academy of Family Physicians, Duke University, Cognosante and Intermountain Health Care and a technical expert panel of the nation's leading minds on the application of information system for children's healthcare.

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Personal Health Records and Secure Messaging for Military Personnel Pilot Program

Although there is significant momentum behind the use of personal health records (PHRs) and other tools for managing and exchanging personal health information, there exists little systematic evidence relating to the benefits of use, especially with respect to clinical outcomes. CHIDS is working with the Air Force Medical Service (AFMS) on a pilot implementation of a PHR and patient-provider secure messaging (SM) technology within the clinical context of specific disease cohorts. The pilot will assess the potential influence of PHR with SM on attitudinal measures and clinical and operational outcomes. It is carried out in cooperation with Deloitte and Relay Health with support provided by AFMS.

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UMD Health IT Seed Grant Program

The University of Maryland Center of Excellence in Health IT Research has made two awards of $15,000 to support promising health information technologies as part of the inaugural Health IT Seed Grant Program. The investments demonstrate UMD's commitment to advancing innovation and research to accelerate the transformation of the nation's healthcare system.

The first awardee team is working with the UMD Medical System to develop a network system to rapidly evaluate patients at risk for oral cancer and improve efficacy, reduce the cost of care, and expand outreach and care coordination. The project, called "A Real Time Electronic Network for Early Oral Cancer Risk Assessment and Detection," will use web-based high-definition video streaming to facilitate head and neck consultations online in real time. This will improve decision making, eliminate the need for multiple referrals and decrease patients "lost in the medical system." The program also seeks to reduce pronounced racial disparities in oral cancer outcomes.

The project is led by Drs. Mark Scheper and Timothy Meiller of the School of Dentistry at the University of Maryland, Baltimore; and collaborators Dr. Douglas Barnes, head of the Advanced Education in General Dentistry Program at the University of Maryland, College Park and head of the Division of General Dentistry, University of Maryland, Baltimore; and Kent Buckingham, director of Information Technology for the Dental School.

The other grant will support a team of doctors working on risk assessments for bone fractures in the elderly. The project, "Investigating Disparity of Bone Health by Integrating Bone Mineral Density Data," will build and test statistical models to improve individual risk assessments using a newly developed methodology called threshold regression. Osteoporosis and bone health are global public health problems affecting more than 200 million people. Across the United States, 10 million people have osteoporosis and 18 million more are at risk. The team will use multiple clinical datasets integrated with health insurance claims to create a combined data warehouse for studying and analyzing bone fractures that may enhance prevention and treatment of bone-related illnesses. They will develop computer software for public use that can produce improved risk assessments. The team's integrated approach and the models and techniques they develop have the potential to be used in many other disciplines and therapeutic areas.

The project team includes lead investigators Drs. Xin He and Mei-Ling Ting of the School of Public Health at the University of Maryland, College Park, and Dr. Marc C. Hochberg who heads the Division of Rheumatology and Clinical Immunology in the Department of Medicine at the University of Maryland, Baltimore.

"We are proud to support these research teams who are applying advanced methods for improving care coordination and using secondary use of EHR data, respectively, and look forward to spurring innovation among faculty, students and partners in future rounds. We are committed to leveraging the rich capabilities and deep resources across the University of Maryland campuses to drive improved healthcare in Maryland and beyond, support economic development and job growth, and continue to firmly establish ourselves as an academic leader in the drive to accelerate health transformation" said Kenyon Crowley, program director for the center.

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School of Public Health - "Public Health Collaboratory for Training and Learning"

The School of Public Health has been awarded $100,000 -- the most any school can receive -- from the 2010 Student Technology Fee fund to develop a "Public Health Collaboratory for Training and Learning." The team leading the project aim to create a space where students and others across campus can "see" and "touch" current and emerging Health IT applications (EHR, PHR, surveillance) in a single location. This opportunity seeks to foster innovation and an improved understanding of potential applications of these tools; it will ultimately enable students to make a difference both in their own health and the health issues of real communities.

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2nd Annual Workshop on Health IT and Economics (WHITE)

Building on the success of last fall CHIDS held its inaugural Workshop on Health IT and Economics (WHITE) in Washington, DC. WHITE's mission is to gather prominent scholars in a multidisciplinary setting to build the foundation for a multidisciplinary health IT and economics research community and to stimulate new ideas applicable to both policy and business. The forum is a great venue to facilitate interaction and collaboration between academia, government, and industry.

The second annual WHITE will be held on October 21-22 in Washington, DC. It will be chaired by CHIDS Director Ritu Agarwal and co-chaired by Guodong (Gordon) Gaoof the R.H. Smith School of Business and Jeffrey McCullough of the University of Minnesota School of Public Health. Todd Park, Chief Technology of HHS will provide the welcome keynote. Over two dozen faculty from leading institutions will share briefs of their leading edge research. Practitioner panels will share the latest in data set utlization, Accountable Care Act implications, ROI of HIT and more. AHRQ and AcademyHealth are providing support. Join us for this high impact event!
WHITE2011 Website & Registration: http://bit.ly/WHITE_2011

Conference support from:


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University of Maryland Fall Health IT Summit

Accelerating Information Technology Enabled Healthcare Transformation in Maryland and the Nation

When: Friday, October 7, 2011, 9:00am - 5:00pm
Where: Stamp Student Union, University of Maryland, College Park

Event website: http://bit.ly/FallHealthITSummit

Hosted by the University of Maryland Center of Excellence in Health IT Research, this Summit will showcase, through its College Park and Baltimore campuses, the University of Maryland's multi-disciplinary resources that are being leveraged to accelerate health transformation. The event will stimulate collaboration between the University and potential partners in government, industry, clinical organizations and advocacy groups. Stakeholders will discuss health IT strategy, policy and technology issues that face Maryland and the nation. The event will also be a forum for engaging students and furthering intra-campus collaboration and research opportunities.

Sign up to our mailing list to receive updates about these events and more!

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CHIDS Co-Hosts 11th Annual CIO Forum

More than 130 people gathered at the Ronald Reagan Building and International Trade Center on Nov. 5, 2010 to discuss "Innovation 2.0: Information Technology in Government and Business" - the topic of the Robert H. Smith School of Business' 11th Annual CIO Forum.

Keynote speaker, Spain "Woody" Hall, Chief Information Officer (CIO) of General Dynamics IT, argued that "it's the people stuff that is really challenging when it comes to innovation. ... Innovation doesn't just happen, it is a process that needs to be managed and driven." Sujal Patel, fouding president and CEO of Isilon Systems, presented "The Era of On-Demand IT - Innovating to Catch the Big Data Wave." Andy Baer, senior vice president and CIO of Comcast Cable Communications, LLC. Baer argued that the digital generation - people who do not remember a time without the Internet - is leading the change in the industry.

The forum was sponsored by the Smith School's Center for Digital Thought and Strategy (DIGITS) and the Center for Health Information and Decision Systems (CHIDS).

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COE HITR Lunch Seminar Series (Ongoing)

The Center has launched a lunch seminar series to create a channel for knowledge sharing among Health IT researchers and professionals. The March seminar featured University of Maryland Economics Professor Peter Cramton discussing Medicare auctions and solutions to correct design problems that could potentially yield billions in savings. In April, Nathaniel Hupert, MD, MPH, Associate Professor of Public Health and Medicine at Weill Medical College, Cornell University and Senior Medical Advisor Preparedness Modeling Unit Epidemiology and Analysis Program Office, US Centers for Disease Control and Prevention (CDC), shared the latest research in applying modeling and simulation for emergency preparedness and disaster recovery. The next seminar is scheduled for Spring 2012.

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Newest Member of the CHIDS Team: Emily McPherson

Emily McPherson has been a CHIDS Research Fellow since February 2011. Manager of CHIDS' social media efforts and Health IT news blog, she also contributes monitoring and evaluation support to several CHIDS research projects. In her previous position as AcademyHealth Research Associate, she facilitated "knowledge transfer" of clinical research from the Agency for Healthcare Research and Quality (AHRQ). Emily has a Political Science BA from the University of British Columbia and an Applied Economics MA from Johns Hopkins University. She also has a baby daughter, Cathleen Aall McPherson. Contact: emcphers@rhsmith.umd.edu  

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Featured Partner: CareFirst

CHIDS is proud to be collaborating with CareFirst to study the potential impact of emerging social media tools and determine the strategic implications for healthcare finance and delivery. The results of this research program may drive processes to improve care coordination, customer service, internal processes and other activities in support of CareFirst' mission to provide health benefit services of value to customers across the region comprised of Maryland and the National Capital Area. CareFirst is an independent licensee of the Blue Cross and Blue Shield Association and is the largest healthcare insurer in the Mid-Atlantic region, serving more than 3.4 million members in Maryland, the District of Columbia, Delaware and portions of northern Virginia.

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Featured 2010-2011 Student Fellow: Helen Culbertson

Helen Culbertson is a consulting professional with significant experience in project management, client relationship management, and data analysis. At Smith, she focused on General Management to pursue a career in consulting and strategy. She has held several leadership positions at Smith, including Vice President of the Women's MBA Association and a Dean's Fellowship. Prior to her arrival at Smith, she held a client-facing role at a small consulting firm where she developed new benchmarks and defined metrics to support her clients' daily decision-making. Last summer she completed an internship with the Government Accountability Office (GAO), where she had the opportunity to shape the initial phases of the GAO's audit of the Federal Reserve. She has since has taken a position with Booz Allen Hamilton where she is working with the healthcare group to improve the value of HIT for federal clients.

Helen is originally from Charlotte, NC, and moved to the DC area in 2007. She went to undergrad in Chicago, IL where she majored in History and Secondary Education. She grew up playing competitive tennis and was captain of her varsity tennis team in college. The competitive drive developed at a young age through sports sticks with her today in career and academic pursuits.

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CHIDS Director Gains AHRQ Appointment and is Named Distinguished Scholar-Teacher

Ritu Agarwal has been appointed to the AHRQ Health Services Research Initial Review Group (IRG), Health Care Quality and Effectiveness Research (HCQER) Study Section. In this role, Dr. Agarwal will review programs related to the quality and cost-effectiveness of healthcare, such as clinical outcomes studies and methods to develop/test quality measures, tools and indicators.

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CHIDS Student Fellows

Ankit Agarwal is a first-year MBA student. He previously worked as a Business Analyst at Computer Sciences Corporation (CSC), India where he specialized in testing and designing the Lorenzo health IT system, which is being deployed across National Health Service (NHS) hospitals in the United Kingdom. He holds a Bachelor of Technology in Civil Engineering from Banaras Hindu University, India. He is interested in exploring how the application of technology in healthcare might improve patients' access to care. He enjoys outdoors activities and playing tennis and badminton.

Santosh Chavan is a second year MBA student. He has worked for 4 years as an onsite project coordinator for telecom client British Telecom (BT) and implemented technology transformation projects in areas of IT strategy and cost transformation. He has expertise in areas of IT systems implementation (SDLC), Program and Delivery management, business process design and data migrations projects. Santosh interned with CSC as Business Analyst creating profitability analysis for Product and Market Strategy group. Santosh is a board member of MBA Consulting Club and Vice President of Student Affairs for the MBA Association.

Andrew Cole is a first-year MBA student at the Smith School of Business. His background in the healthcare industry includes experience at CIGNA Healthcare focusing on outsourcing and operational improvement initiatives, as well as at a privately-held health information technology company where he developed and supported their patient management and health information exchange strategies. Andrew is interested in exploring how technology can be utilized to simultaneously improve patient care and reduce medical costs.

Clay Gaynor is a second-year MBA at the University of Maryland's Robert H. Smith School of Business. Prior to business school, he worked in print and digital media - first at Washington Life Magazine, a regional lifestyle publication, and then at Virilion, an interactive media firm in Washington, DC While at Virilion, Clay worked for a variety of clients, including PhRMA's Partnership for Prescription Assistance. Clay recently completed a graduate internship at Choice Hotels International, where he worked on the company's co-branded credit card and other rewards program initiatives.

Brad Greenwood is a fourth-year PhD Candidate in the Decisions, Operations, and Information Technology department. His research focuses on how discourse affects the perception of the "fashionability" of technology as well as gauging quality through different mediums of physician review. He earned his Bachelors and Masters in Information Technology at Rensselaer Polytechnic Institute and Virginia Tech respectively. He also holds an MBA from the University of Notre Dame and spent several years working as an IT consultant in the greater DC area.

Adam Kowalsky is a second year MBA student. He previously worked on Capitol Hill in the Washington, DC office of the Governor M. Jodi Rell (CT), where he worked on many issues including health and human services as well as environmental and energy issues. As the respresentative for the Governor, Adam worked closely with Congress, the Administration and the National Governors' Association. At Smith, he serves as the Executive Vice President of the MBA Association and enjoys spending his time playing on multiple intramural teams.

Shannon Lantzy is a second-year PhD student in Information Systems. Her health IT research interests include the impacts of IT on patient experience, the role of online information in provider choice, and meaningful use of health IT. Her other research interests involve studying the nature of online community membership and participation. Shannon recently finished her Masters of Information Management at UMD's iSchool. In the seven years before coming to Smith she worked as a management and IT consultant at NASA Headquarters.

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