Coast-to-Coast Conferences.

Upcoming events focus on security and practical applicability.

The dot-com meltdown may have rocked Wall Street, but it has not deterred organizers and speakers of two upcoming conferences from extolling the virtues of technology.

"I remain a bull on Internet applications in this industry," says Jeff Goldsmith, president of Health Futures Inc., and one of the keynote speakers slated for this year's eHealthcare World conference. Likewise, Peter Waegemann, CEO of Medical Records Institute, the sponsoring organization of this year's TEPR (Toward Electronic Patient Records) conference, states, "e-healthcare is more than a gold rush for some companies. We have finally come away from the hype."

The TEPR conference will be at the Hynes Convention Center in Boston, May 8 to May 13 and the eHealthcareWorld conference is scheduled for the San Diego Convention Center from May 23 to May 25. Both will address many of the same hot issues: security safeguards based on HIPAA standards, leveraging emerging technologies, and achieving true connectivity through integration.

Perhaps the biggest similarity between these two conferences will be a focus this year on the practical application of technologies that have already begun to change the way healthcare is delivered.

The TEPR Challenge

The movement away from paper documents and toward a wider use of electronic patient records (EPRs) presents very real challenges, admits Waegemann. Among the most critical are security issues, which is why approximately one-third of the programs featured at this year's conference will focus on security. In fact, Waegemann said there will be 20 separate sessions on HIPAA alone.

While access to patient records has become a concern of physicians and CIOs alike, Waegemann notes, "The old ideas of computer-based patient records is dead." New ideas involve the use of "components" like personal digital assistants and clinical work stations. "At the same time, we're moving to records being put on websites, available to patients and physicians."

He notes that while the movement toward all-digital records has been slow, there are reasons why clinicians still rely on paper records. "Ninety-nine point nine percent of hospitals and clinics still use paper records for legal purposes. There are more regulations in healthcare than in other industries. Take signatures. One surgery form may need to be signed by 17 persons. There is no other industry where you have as many regulations for signatures and documentation."

Eye Spy

Of the 400 speakers scheduled for the TEPR conference, Richard Downing, a senior consultant for Gartner, will address a number of security issues. In fact, Downing will chair a panel on May 11 focusing on the use of biometrics.

Biometrics is often portrayed in science fiction as a means to access secured areas. But myths must be separated from the realities, Downing says. While it can be used to protect high-security areas of a hospital and is already becoming a low-cost replacement for key card access, biometrics can play a major role in combination with other security safeguards.

To explain this, Downing points to other forms of security now being implemented in healthcare organizations. "PKI (public key infrastructure) will authenticate a particular machine to another machine so an insurance company, for example, can trust that that machine was the originator of the request. But biometrics makes sure it was the right person who originated the request," he says.

A virtual private network (VPN) also can be used to protect information traveling across a network, although Downing says it won't keep a PC from being compromised. "With a VPN, you're still exposing your whole corporate network," he warns. The solution, according to Downing, is to tie biometrics into a multi-faceted security system.

Like other types of security, biometrics is rapidly changing. Although retinal scans were once widely used, Downing says the trend today is toward iris scans which can be done by using a simple camera similar to the desktop cams most people now have perched on the top of their PCs. In addition, biometrics is expanding to include facial recognition and hand geometrics. There's even a "biometric mouse" which looks at the user's thumb print.

During the conference Downing will demonstrate just how easy it is to use biometrics by "authenticating" members of the audience. "With HIPAA, you'll see biometrics taking off as an industry."

Practicality Rules

Waegemann says the 4,000 to 5,000 people expected to attend the 17th annual TEPR conference will also gain more practical solutions than in past years. He himself is scheduled to speak on a number of topics related to electronic patient records and explains that the main sessions this year are grouped into four major categories. Connectivity sessions will focus on using information technology as a tool to enhance the provider-payor-patient relationship. Clinical documentation sessions will provide insight into the challenges and opportunities involved with speech recognition, clinical processes, coding, data warehousing and mining, transcription and decision support. HIPAA sessions will address HIPAA implementation issues while offering solutions for financial and administrative transactions, privacy regulations and security. The HealthChoice category will explore the shift from a transaction-centric model of care to a patient-driven model by answering the questions, "Who are the new health consumers, what do they want and who is providing the best interactive choices to support health prevention and management?"

In addition, this year's conference will include 25 separate tutorials covering a wide range of topics: a primer on data warehousing; document imaging and knowledge management; Internet and wireless technologies; building a physician portal; acquiring and implementing clinical information systems; standards for electronic patient record systems; and how to avoid the pitfalls in planning and implementing EPR systems.

There also will be a two-and-a-half-day mini-conference on PKI and a two-day nursing informatics workshop, Waegemann notes.

Tools for eHealthcare

The eHealthcareWorld conference in San Diego will focus on providing practical solutions through the use of new technologies, says Julie Brown, the conference's content chairperson. Brown admits there is still some skepticism concerning the role of the Internet and digital technologies in healthcare. But she notes that this conference will provide an insight into which technologies are the best to use for solving specific problems. After all, she states, "e-health is a tool, not an industry. While the financial market is in a downturn, there has been an upswing in the adoption of these technologies."

Brown says in the past, substantial emphasis went to website development and Web-enabled applications. This year's conference, however, will show how healthcare organizations can use the Internet as just another tool. "People will see that the Internet is a common platform that can get the right information to the right person at the right time."

Helping to dispel some of the myths surrounding the Internet during the conference will be Jeff Goldsmith who, besides being president of Health Futures Inc., is associate professor of medical education in the School of Medicine at the University of Virginia.

Goldsmith expects to "talk a lot about the perception of a `pause' in rolling out the Internet" and "to dispel the idea that the Internet was a `media event' propagated by Wall Street." There is a tremendous pressure being put on hospital CIOs to use the Internet and in some cases, this has created a schism between departments. "There actually is a struggle in healthcare facilities as to who owns the Internet strategy, marketing or IT. Actually, it's neither.

"I see the Internet as a gateway to de-aggregating hospital services," he adds. Admittedly, some individuals have been reluctant to fully embrace the Internet as another tool in their healthcare toolbox. But Goldsmith says, "The problem is the unfriendliness of interfaces. It's a requirement that the interfaces need to work better."

Goldsmith doesn't deny that security is a problem, but he also believes that many of the concerns now being expressed go well beyond use of the Internet. "Privacy hasn't been as important as it should be," he notes. In fact, he applauds HIPAA standards. "It's important for this industry to protect the privacy of patients. I think HIPAA was absolutely necessary."

Different Strokes and Folks

Although security and HIPAA compliance presentations will draw attention from many of the more than 5,000 people expected to attend this year's eHealthcare World, Brown says the conference also will provide information on wireless technologies and the business of e-health.

If, after all, you can judge a book by its cover, then the juicy break-out session titles foretell tough decisions ahead for convention attendees. How do you choose from among sessions like these: Bridging the Digital Divide; Virtual Surgery; The End of "Errers;" or HMT's personal favorite, I Want What I Want When I Want It: The Patient Perspective? Add to those a couple of keynotes by luminaries such as Dr. David Kessler and Kenneth Abramowitz, and a content-rich week takes shape before your eyes.

As with last year's event, this year's conference will be divided into educational tracks for hospital executives, managed care organizations, pharmaceutical companies, physicians and payors. Track 1 is for physicians, focusing on new and emerging electronic technological advances on medical education; information storage, processing and retrieval; and consultation and monitoring for patients at distant sites.

According to Brown, these specific educational activities have been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Stanford University School of Medicine and eHealthcareWorld. The Stanford University School of Medicine designates this educational activity for up to 12 to 15 hours in category 1 credit towards the AMA Physician's Recognition Award. However, each physician should claim only those hours of credit that he or she actually spent in the educational activity, Brown says.

Track 2 will focus on hospital, health system and provider strategies and will explore emerging technologies and Internet-based strategies from the caregiver perspective. Track 3, for payors and purchasers, will cover online claims adjudication, physician-provider-patient connectivity and communications, and Web strategies for payor constituencies.

Track 4 focuses on the business of e-health including business models such as ASPs and B2Bs, content and marketing strategies, asset management strategies, financing, legal issues, and wireless and broadband delivery strategies.

For representatives of pharmaceutical and biotech companies, track 5 will concentrate on clinical trials and patient recruitment, new innovations in D2C marketing, global knowledge and data sharing, and issues of standardization and privacy. Track 6, for e-health professionals, will cover current successes and failures in capturing market share; extending your brand to the offline market; pre-launch marketing; online market research strategies; and physician behaviors in Internet usage. The conference also will include an "e-VentureForum" and a "Womens Leadership Forum."

Brown says that even with six tracks, a single thread unites the components of the whole event. "The `e' in e-health--efficiencies, emerging technologies, education, evolution--still holds the promise to transform the industry," she says.

Richard R. Rogoski is a free-lance based in Durham, NC, and a contributing editor to HMT. Contact him at [e-mail].