On stage at Maine’s HIE, Todd Rogow directs

By Bernie Monegain
04:25 PM
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Todd Rogow does double duty for health information technology in Maine. As director of IT for HealthInfoNet, Maine’s statewide health information exchange, he provides the technology expertise and leadership for health data exchange across the state, and he also serves as director of Maine’s regional extension center (REC), which is tasked with bringing physicians on board with electronic health records.

Exchange executives recently announced a new milestone ¬– the start of image-sharing across the state, probably the first HIE in the country to exchange images at this scale (see page TK). As director of IT for the HIE, Rogow redesigned both the makeup of HealthInfoNet’s clinical exchange system architecture and vendor mix while reducing annual operational expenses by 60 percent.

Before joining HealthInfoNet as its fifth employee, Rogow led project teams of up to 300 people for Northrop Grumman, working on nationally recognized programs such as the Armed Forces Health Longitudinal Technology Application (AHLTA), the largest electronic health record system in the world.

Rogow has provided business and consulting services to a range of Fortune 100 companies, including defense, telecommunications, manufacturing, and natural resource industries.

Rogow hails from Vermont, and was always eager to return to New England, he says. He and his wife have two children, ages two and four, which leaves little time for non-work activities, but he enjoys wildlife photography, gardening and running.

Q: Why IT?
A: IT in general has provided me an opportunity to work across many industry sectors. I have enjoyed the challenge of solving complex organizational problems by leveraging technology to streamline business processes and provide customer-facing services.

Q: Why health IT?
A: I enjoy health IT because it applies cutting-edge technology to save lives and improve the quality of healthcare overall. It is satisfying to help clinicians and empower patients in the treatment process.

Q: What drew you to your work at HealthInfoNet?
A: HealthInfoNet’s success and broad stakeholder support in standing up one of the very first clinical exchanges in the United States was attractive. Also, having to chance to work with a visionary like Devore Culver, past CIO of Eastern Maine Healthcare Systems, played into my decision to join HealthInfoNet. I was employee number five, and today we have grown to 15. Having an opportunity to be part of a growing company and help to shape its growth added some extra challenge and excitement to joining HealthInfoNet.

Q: What has been your greatest challenge so far as HealthInfoNet’s director of IT?
A: Making the transition from one primary vendor to another and bringing the operation responsibility of the HIE in-house in late 2010. With an amazing effort by HealthInfoNet staff, consultants, and vendors, we rebuilt the system architecture of the HIE in four months – something that few thought was possible. I led the effort to select new vendors, negotiate four major contracts, and build a new data center. This transition included a replay of more than 38 million historical messages in the newly designed clinical exchange.

Q: Does Maine provide unique challenges for health data exchange?
A: I’m not sure there are many unique challenges, but certainly the participants in HealthInfoNet offer several advantages that support health data exchange. The majority of them have agreed to not compete over patient data in support of the clinical exchange. There has been strong support and a willingness to collaborate across a diverse group of healthcare organizations

Q: What about HealthInfoNet’s best-of-breed approach? Doesn’t that make everything more complicated?
A: It can, but my in my experience if done in moderation a mix of vendors can provide many benefits to the organization. Bringing together the best technologies/vendors for major components both enriches the set of features offered, strengthens your overall technical solution and encourages vendors to innovate in support of your business and customers.

Q: Recently you announced the launch of image-sharing capabilities. Why is that critical?
A: HealthInfoNet’s mission is to present the most critical clinical data to best support clinicians’ care of their patients. Including images in our service will allow providers to view a timeline of images/studies (relevant priors) collectively across organizations in real time.

Q: Have other HIEs across the country shared images, too?
A: Yes, there are a few, but I do not know of any that are focused on providing a comprehensive statewide solution.

Q: What do you wish you could have accomplished that is not yet done?
A: While this is a moving target and always will be, I wish we could say all patients and providers in the state knew about the HIE. Our usage numbers are climbing every day and patients are starting to talk with their providers about the use of the HIE, but much work remains in educating both providers and patients about how the HIE helps support care in Maine. We’ll get there, though.

Q: What is the single best thing HealthInfoNet has been able to do so far?
A: It is hard to single out just one major accomplishment that HealthInfoNet has achieved, but I will say that without the continued support from our participants across the state, none of this would have been possible. I believe we are just now on the verge of demonstrating real value as our health care system adopts risk-based, patient-centered models of care. I’d have to say the single best thing is the HIE itself and its success. HealthInfoNet now covers more than 80 percent of Maine’s population, 71 percent of all inpatient discharges, 68 percent of all outpatient visits and 70 percent of all emergency department visits in Maine. That’s pretty cool!

Q: What advice do you have for other HIEs?
A: The value of health information exchanges is just now starting to be better understood by both provider organizations and patients. Listen to your participants to better understand their needs then focus on services that will build a stable foundation for future growth. Don’t be afraid to take risks, but also learn as much as you can from others about the services and technology approaches that provide the most value.

Q: With HIEs everywhere taking unique approaches to data exchange, will it make it harder to connect to the nationwide network?
A: It can make things challenging, but a lot of effort is now being spent on standardizing approaches to make sharing clinical data possible.

Q: The Nationwide Health Information Network (NwHIN) is expected to be ready in October. When will HealthInfoNet be ready to link?
A: We have been engaged in a pilot project with the federal CDC that leverages NwHIN Connect for de-identified meaningful use population health measures. This month we will also be offering NwHIN Direct services statewide for providers who are looking for a more secure way of exchanging clinical data between individuals.