NiyamIT, Inc.'s VP for Health IT Practice, Mr. Robert E. Connors, FACHE, PMP, attended the DHITS Conference at the Caribe Royale Conference Center, Orlando, Florida, Aug 17 - 21 August 2015.  Kudos to Ms. Alida Vessey, Conference Manager, who organizes an excellent, value-added conference for both military and vendor attendees.  The purpose of the conference is for the Military Health System to share information on IT developments with its own staff, as well as to set forth projected requirements for the vendor community. 

Mr. Connors attended a number of keynote presentations and break-out sessions to learn about emerging health IT requirements in the Defense Health Agency, and Army, Air Force, and Navy Medical Departments.  He also spent considerable time collaborating with other vendors on the DHITS Exhibition floor to learn about their capabilities, and discuss potential teaming opportunities where applicable.  Mr. Connors spent considerable time, walking the floor to discuss NiyamIT, Inc.'s capabilities in big data on Hadoop, geographic information systems, advanced analytical visualizations, predictive analytics, and strong cloud/mobile solutions.  As with any conference, the big pay-back will be dependent upon persistent follow-up with the business contacts made.

Much of the attention at the DHITS conference centered around the Leidos/Cerner/Accenture exhibit and a demo of Cerner Millennium Unified Architecture, as this team and their partners were awarded the $4.3 Billion Department of Defense (DoD) Healthcare Management System Modernization (DHMSM) procurement. Clearly the focus over the next 3-7 years will be to deploy the Cerner EHR to 65 military hospitals, and 400 medical and dental clinics.

However, DOD will still have to maintain about 200 other business management, logistics, and clinical intelligence systems, many of which connect to the current DOD EHR (AHLTA, CHCS and Clinicomp Essentris). The conventional wisdom that until DOD gets the Cerner EHR deployed, any modernization of other systems, and any efforts to improve analytics may be minimal.

Probably the biggest news of the conference was Defense Health Agency's intent to develop its own separate medical IT communications network, which is envisioned to better serve DHA's increasing need for dedicated bandwidth for its critical life-saving operations, to include transactional clinical encounter and admission documentation; big data analytics for population health, chronic disease management, biosurveillance, and pharmacovigilance; increasing consumer healthcare and home telehealth; and its primary reason for existence, theater operations.  How this plays out against other efforts to consolidate networks and data centers is to be seen.  

There is always concern about whether a separate medical network, outside of big DOD control, would adversely impact privacy and security.  The reality is that medical information on DOD beneficiaries already has a separate network, in that two thirds of military beneficiaries receive care in private civilian hospitals, who have their own clinical systems.  Of course, there were many sessions which spoke to the continuing efforts of DOD to work with Office of the National Coordinator of Health IT, to continue health information exchange sharing efforts, through the Sequoia Project (formerly eHealth Exchange, and NwHiN), and NwHIN Direct, as well as new emerging HL-7 FHIR standards.  There will also be continued pressure to share data with the VA Vista System, as the Cerner EHR is implemented.

Currently DOD exchanges information with the VA through the BHIE/CHDR interface, through HAIMS, and to some extent from the old NHIN/VLER efforts. There are also a number of point-to-point health information exchanges that local MTFs have developed with their regional HIE providers.  Achieving semantic interoperability will be evolutionary, vice revolutionary, and will take time.  The good news is that as a result of the Affordable Health Act and HiTech Acts, standards have developed to the point to make effective health information exchange possible.

One session of particular interest was a Military Health Innovation panel consisting of Dr. Steve Steffensen, MD, Chief or MHS Innovation; Colonel Dan Kral, MS, USA, Director of TATRC; Mr. Andrew "Jake" Jacobs", DHA Innovation; and Captain Paul Miller, MSC, USN, from the Pacific Joint Interoperability Test Center (PJITIC).  LTC Mark Mellot, USA, who chairs the Joint Program Committee-1 for Health IT, moderated the session.  These speakers shared their thoughts on how to institutionalize innovation across the enterprise, without stifling it in bureaucracy; various funding mechanisms to spurn development and adoption of emerging health IT, such as Rapid Innovation Funding (RIF), Small Business Innovative Research (SBIR), and Small Business Technology Transfer (STTR) programs, and DHA's new internal portal for MHS members to submit innovative ideas (which may be opened later to industry).  Dr. Steffensen emphasized his current efforts to catalog DHA's current and emerging relationships with industry, academia, and other government agencies, oriented towards health delivery (and the need to move to health), education, and consumer engagement, across the garrison and operational theaters.

The DHITS Conference was of a manageable size to attend and benefit.  It is also a good warm-up for the upcoming February 2016 HIMSS Annual Meeting, which is mostly viewed as an overwhelming extravaganza by many. Mr. Connors plans to attend that meeting on behalf of NiyamIT, Inc.  He has also been active planning a HIMSS Innovation Pre-Symposium meeting, as a member of the national HIMSS Innovation Committee.

(Courtsey: Robert Connors, VP Health IT Practice)

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