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Judy Faulkner readily admits that when she founded Epic Systems she had no idea how to start a company.  Faulkner discussed those early years as well as some of today’s most contentious topics including semantic data interoperability, why the U.S. needs a unique patient ID, and the impact that electronic health records software has on physician productivity. Semantic standards are key for data exchange. If you're going to do interoperability between organizations, which I think is critical, it's limited because you have to define and normalize and harmonize the data so that each group can understand the other. Let's examine gender. I may have one for male, two for female, and then two other kinds of genders, ambiguous and something else. [Also: Judy Faulkner: 'Good software is art.'] On the other hand, they may have one for female and a range of other values. How do you move that over when different groups have different ways of doing that? You need standards. There's a limited number of standards that we have to be able to transmit the data. I use such a simple example as gender, but as you go into the drug and other databases, there is even greater complexity. Within your organization you want to share. It's critically important to also get information back and forth from other groups who aren't yours. Unique patient ID has to happen. I think each person should have a medical identity. I don't care whether it's federal or not. However, the lack of this is not an excuse. You can do a lot of patient matching based on other attribute checking and so the identity would make it easier, but it is not an absolutely critical thing. Remote care is the future. Healthcare going to stay local to a great extent. I think it's going to also move to telemedicine much more than it is right now because we have to reduce the resources that we're using and the expense that we have in healthcare. Also people don't want to travel if they can help it. It will be a little slower than people would like. Physician productivity among Epic's priorities. Make sure your doctors are productive users. Focus on your doctors being productive users and all your users being happy. Because if that happens, then the rest will just fall out. Doctors happy, No. 1. And doctors happy means that they're taking good care of their patients, by the way, because doctors will not be happy if they're not, and I think that's really important, so I don't want to separate that out. 'I had no idea how you start a company.’ After I built it, I went around to a lot of different departments in University of Wisconsin and worked with them. One department had money for six months for a programmer to do something. There were only 20 data elements, and I remember charging them for 45 minutes of time. You can see why customers all around the country told people, ‘Look what they are doing." They'd call me up and say, "Start a company," and I would laugh and say, "No." This went on for about two years. Finally I said ‘Yes.’ You have to realize I wore blue jeans. In the summer I wore T-shirts; in the winter I wore sweatshirts. I cut my hair with scissors, no makeup. I was a normal programmer and I had no idea how you start a company. So I went to somebody who had spun off from the university, and he said three things: One, get permission from the university, get a good lawyer, get a good accountant. I did all three. It was great advice. I started the company, valued it at $70,000, and I invited my customers to join in and be part of the original shareholders. There are a lot of people then who helped start Epic … We divided it up, so if you had 5 percent of the company, you paid $3,500, and that got us started. We started with one and a half people. I had a morning assistant and an afternoon assistant. We were in a basement of an apartment house. That was it. We signed a bunch of contracts and never took outside money from venture capital or went public or anything like that. Twitter: @HealthITNews

Ransomware attacks on healthcare and other organizations “will wreak havoc on America’s critical infrastructure community,” according to a new report that also found the malware is now so prevalent it’s creating an economy of its own.

EHR giant Cerner on Friday completed the initial stage in a $4.5 billion expansion that company officials and the state’s governor are promising will add thousands of jobs. Missouri Gov. Jay Nixon said at the ceremony that the area is already seeing benefits of this project, pointing to nearly 4,000 jobs created. “Once complete, this campus will accommodate Cerner's growth and bring up to 16,000 new jobs to the area strengthening Missouri's position as a top destination for growing tech companies,” Nixon said.    Kansas City has been rebranding itself as a technology innovation hub some people have been calling it Silicon Prairie for the last several years, looking to attract entrepreneurs and employees alike. The region, in fact, was the first to implement the Google Fiber gigabit Internet service. In addition to Cerner, other technology companies in Kansas City include Sprint, DST Systems, and Garmin. Cerner’s construction ceremony on Friday “marks significant progress for the project and completion of the structural framework for the first two office buildings on our new campus," Cerner COO Mike Nill said. Nill announced the first buildings would house more than 3,000 engineers and was designed with open concepts and collaborative meeting spaces to encourage creativity and community. When Cerner first broke ground on the new campus, in late 2014, the company said it intended to add 16,000 jobs in the next decade. Twitter: @HealthITNews    

Pieces Technologies announced $21.6 million in its first round of funding to advance its cloud-based population health management tools. The Pieces platform provides integrated monitoring, prediction, workflow optimization and organizational learning services specifically for hospitals, health systems. Its cloud-based software is also designed to connect to hospitals’ information systems to provide a holistic view of patients and their healthcare needs. [Also: Hospitals driving population health with data analytics, mobile apps, telehealth tools] The goal is to identify and prevent adverse events, such as avoidable mortality and hospital readmission for chronic diseases and illnesses, according to Pieces CEO and founder Ruben Amarasingham, MD. “Pieces Tech’s solutions are helping us redesign and transform our healthcare delivery models for better population health management,” Fred Cerise, MD, Parkland Health and Hospital System’s president and CEO, said in a prepared statement. Parkland’s non-profit research and development arm, Parkland Center for Clinical Innovation, served as an incubator for the platform. [Also: Healthcare IT startups to watch in 2016; Running list of big news]  “While many purport to have solutions for population health, over the last several years the team has stealthily built and validated a robust healthcare IT and clinical services platform that has clinically proven to truly bend the cost curve on quality and care across diverse constituencies,” added Garrett Vygantas, MD, Partner at Jump Capital. Jump Capital and Pacific Advantage Capital led the funding, along with participation from Children’s Health in Dallas, Order of Saint Francis Healthcare System in Peoria, Ill, PCCI, select Dallas investors and others. Twitter: @HealthITNews

A whistleblower blog claimed many other executives within the NYC Health + Hospitals EHR project were deeply concerned. But the health system countered that the electronic health record software would be ready by implementation.

The Office for Civil Rights used the instances to highlight the importance of holding business associates and research centers accountable to privacy and security laws.

A hospital official says no patient data was compromised and the IT staff wiped the infected systems clean. 

Medsphere Systems Corp., whose OpenVista electronic health record is based on the architecture of the Department of Veterans Affairs' VistA EHR, has released a mobile version of the technology called Mobile OpenVista Enterprise, or MOVE. With secure and real-time access to patient data wherever a clinician has Wi-Fi or cellular coverage, officials say MOVE – which includes Medsphere's NoteAssist patient documentation system – allows physicians and nurses to review medication orders and record patient information on the go. [Also: OpenVista EHR maker Medsphere merges with MBS/Net] "Without doubt, healthcare IT is moving toward mobility and enhanced, streamlined processes," said Medsphere President and CEO Irv Lichtenwald in a statement. "Medsphere is excited about moving OpenVista in that same direction." On March 17, Medsphere also announced an expansion of it products and services since its recent mergers with Phoenix Health Systems and MBS/Net. Phoenix Health continues to integrate its infrastructure support and application management skills with Medsphere's offerings. Meanwhile, MBS/Net's technology, such as physician practice management system and ambulatory EHR, are being integrated with OpenVista, officials said. Twitter: @MikeMiliardHITN

The U.S. Department of Veteran Affairs’ use of telemedicine to treat patients at its Vermont hospital at White River Junction resulted in an average travel payment savings of $18,555 per year between 2005 and 2013, according to a study published in the journal Telemedicine and e-Health. The study found that telemedicine resulted in an average savings of 145 miles and 142 minutes per visit, resulting in the aforementioned payment reductions, while telemedicine services volume grew significantly over the study period such that by the final year the travel savings had increased to $63,804, or about 3.5 percent of the total travel pay for that year. [Also: VA picks up $233 million from Congress to fund VistA EHR upgrades] Authors of the report explained that the number of mental health telemedicine visits increased during the study period but remained small relative to the number of face-to-face visits. And a higher proportion of telemedicine visits involved new patients. On a nationwide scale, the VA has taken strides to use telehealth tools for treating its patients. For example, an August 2015 study determined that older veterans with depression benefited from telemedicine talk as much as in-person therapy sessions. That study, published in The Lancet, found that older veterans with depression benefited from telemedicine talk as much as in-person therapy sessions. With many seniors facing difficulties to getting help for depression, including mobility issues and fear of social stigma, telemedicine can increase their access to treatment, the study found. And with the national VA healthcare system’s travel pay to patients for getting to appointments projected to cost nearly $1 billion in 2015, a 3.5 percent reduction, if achievable at scale, can yield significant savings. Twitter: @HealthITNews

A new report from the President’s Council of Advisors on Science and Technology claims technologies such as telehealth and wearable sensors should be put to work to help more elderly Americans stay healthy and connected as they age. The report by PCAST, an advisory group of scientists and engineers appointed by President Barack Obama to make policy recommendations related to technology and science, found these types of technologies can help elderly Americans face challenges tied to social connectivity, emotional health and cognitive and physical ability. "With many Americans wishing to live in their homes and communities for as long as possible, technology such as prosthetics, wearable sensors, and other tools for daily living can make that possible," said PCAST members Christine Cassel and Ed Penhoet. [Also: Mobile apps emerging as essential population health tools] As of 2014, an unprecedented 15 percent of the U.S. population was over the age of 65, according to the Census Bureau, and many of them remain active. Recommendations also include creating better access to the Internet as something essential to health, social engagement and well-being, and offering more education and training for seniors in online technologies. PCAST also suggests greater efforts by technology providers to develop monitoring tools for frail and vulnerable elders. But the report also calls on a federal agencies to make changes. Specifically it pointed to telehealth as something with clear benefits for seniors living remotely or with limited mobility – but said the government needed to update regulation and payment policies to reflect recent innovation in the space. For another example, the Federal Trade Commission should continue to enforce regulatory review and guidelines for commercial cognitive training products, PCAST said. [Like Healthcare IT News on Facebook] And the group called upon an array of federal agencies – from the National Institutes of Health to the Defense Advanced Research Projects Agency, or DARPA – to expand research on projects such as robotics and advanced mobility technology. It also recommended that Centers for Medicare and Medicaid Services payment policies should be adapted to increase seniors' access to those next-generation tools. "Technology has played an important role in increasing life expectancy, but it also has an important role to play in increasing the quality of life by maximizing Americans’ ability to function in their later years," PCAST Chairs John Holdren and Eric Lander wrote in a letter to President Obama. Twitter: @MikeMiliardHITN