With a nod to Apple and its famous 1997 TV spot, which highlighted doers and dreamers in all fields of endeavor – those who colored outside the lines, we put the spotlight on just a few of the many "crazy ones" who are helping transform health IT in new and unique ways.
Don't tell Amy Abernethy that something is impossible. The oncologist, researcher and associate professor at Duke University Schools of Medicine and Nursing, has made it her mission to go after the seemingly unsolvable. When it comes to cancer, she's convinced the answers reside in the data. It's just a matter of finding the right combination that will unlock the solutions.
"In the statistical world, we say that getting your data set right is 90 percent of the task, and everything else is now doing the analyses, which you've already planned out once you've gotten your data set right. And, this is getting the data set right at scale."
Devore Culver is behaving like a kid with a new toy. What is engaging him, however, is not child's play. It's the critical endeavor of making patient care better and perhaps even reducing the cost of healthcare at the same time. Serious business, and he's fully aware of it. At the same time he's completely captivated with what the technology can do – slice and dice the movements of patients, all of them part of Maine HealthInfoNet, the statewide HIE.
"This allows any provider who's connected to HealthInfoNet to get to look at the question as to where patients are going and who they're going to across the state," he said, as he demonstrated exactly how he does it. "And, it's filtered by things like diagnosis or disease, so, if I want to ask the question, 'Where are all the hip replacements going for my town?' I can actually call that up. I can look at myself in comparison to others – see my diagnosis or disease."
Though Culver has been around health IT for decades, it's clear he's still smitten.
As CEO of the HIE, Culver wants it to be the best – a model other states might mirror.
Donnell created the long-running satire project Extormity.com – a fictitious EHR company ("at the confluence of extortion and conformity") that embodies the worst impulses of vendors: proprietary, price-gouging, pompously dismissive of workflow and interoperability.
He launched the project both to call out some of the industry's worst excesses – while also getting some viral marketing on the cheap, slyly positioning NMC and its parent company Medical Informatics Engineering as the antithesis of Extormity. The industry response to the wickedly funny Extormity "has been unbelievably positive," he says.
Faulkner founded Epic in 1979, at a time when most healthcare systems still kept patient records tucked away in manila folders. She was a math major in college and studied computer science in graduate school. She coded the first Epic software herself. Today she is listed as one of the few healthcare billionaires on the Forbes billionaire's list, along with Neal Patterson, who heads rival health IT company Cerner.
Faulkner, who sits on the federal Health IT Policy Committee, keeps a low profile and typically shuns interviews. She draws criticism for what her critics say is her product's lack of interoperability, which Epic executives only recently countered.
Halamka might have been labeled the multi-tasker. He is that. But his interests and work is so much larger than that, that we dubbed him "The Renaissance man." He launched work on health IT standards long before many industry insiders realized they were needed. He, and a cadre of other volunteers have been at the drawing board for many years.
Halamka is a doctor, a CIO, an author and blogger, a climber, musician, vegan, beekeeper and most recently a farmer. He and his wife are building Unity Farm, with more than 100 animals and countless crops. He chronicles the challenges and joys of both farming and health IT on his Geek Doctor blog.
For all the progress healthcare has made with regard to technology, there's so much further we can go, says Daniel Kraft, MD.
"Because there's so much unmet need, we have so many technologies that are sort of layering up," says Kraft, a physician, biomedical researcher, inventor, entrepreneur, Stanford faculty member, pilot and flight surgeon with an F-16 Squadron of the California Air National Guard.
Kraft chairs the medicine track for Singularity University, which was founded by futurist Ray Kurzweil to speed the understanding and deployment of boundary-pushing technologies, and he's the founder of Exponential Medicine, a yearly conference (the next one is in November, in San Diego) that explores emerging and convergent technologies that can transform healthcare.
Electronic health records are only the very beginning. So many other technologies are poised to fundamentally alter care delivery, says Kraft – pointing to one instance of how disparate technologies have come together to upend another industry.
There was no Epic or Allscripts. It was long before the days of meaningful use. In fact, there was no full electronic medical record system in the nation to speak of. Clement McDonald, MD, recalls those days with ease.
It all took place beginning in 1972 at the Regenstrief Institute when McDonald and a few colleagues took it upon themselves to develop what was widely considered to be the first EMR system in the country.
What's more, no one had asked him to build it. “We were sort of mavericks all along,” he says, chuckling. McDonald had been planning on building a system since the mid 1960s, a plan stemming from what he observed while interning at Boston City Hospital, where hospital admissions were an ordeal in their own right.
"It took five or six hours to admit one patient before we had all the data."
When asked if she's against health information technology, Deborah Peel laughs. As a psychiatrist, Freudian analyst, and one of the nation's most outspoken advocates on behalf of patient privacy, Peel says it was never about the technology.
"Technology is absolutely not the problem," she points out. Growing up, Peel observed that problems with an infinite number of variables could often be solved by computers, a lesson from her father, who was an internationally recognized computer scientist and finalist for a Nobel Prize.
"The problem is our laws and policies and the fact that health information is the most valuable information about you in the digital age." And because health privacy laws and policies remain grossly lacking, IT has subsequently not been designed with privacy at the core.
"Medicine today invests heavily in information technology, yet the promised improvement in patient safety and productivity frankly have not been realized," Pronovost testified at a Senate hearing on July 17.
"Why is it when a death happens one at time, silently, it warrants less attention than when deaths happen in groups of five or 10?" he asked. "What these numbers say is that every day, a 747, two of them are crashing. Every two months, 9-11 is occurring … we would not tolerate that degree of preventable harm in any other forum."
Pronovost has been relentless in not only calling attention to patient safety issues, but also in finding ways to solve them -- going back to 2001when he designed his checklist for avoiding central line infections.
Atul Gawande, MD, a maker of checklists himself, wrote about Pronovost's initiative in The New Yorker (Dec. 10. 2007).
Sensmeier started her career at Palos Community Hospital in Shaker Heights, Ill. It was not long before she was charged with computer training for the hospital. Sensmeier took to her dual role as nurse and computer guru. It satisfied her desire to make a difference and her penchant for detail.
In 2000, HIMSS recruited her to be its first advocate. She jumped at the opportunity to grow her skills and to have even more impact on patient care through her work not only on informatics, but also on interoperability. Sensmeier started the Connectathon more than a dozen years ago. The growing and popular Interoperability Showcase at the annual HIMSS conference was her brainchild -- now evolved far beyond what she first envisioned.