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HIMSS NorCal Newsletters

By Dmitriy Reznik, PA-C

Can a brick-and-mortar non-profit mental health institution with a minimal budget and a long-standing unease with technology transition into a fully functional virtual behavioral health program? Can it do so in less than a week while innovating a new model of “tele-PHP” care? While keeping over 30 patients in treatment?

Spoiler alert: Yes, it can -- and patients love it!

Day One: Crisis

As the coronavirus spread and the second week of March 2020 came to an increasingly frightening close, La Cheim Behavioral Health Services, a non-profit that operates a Partial Hospitalization Program in Oakland, CA, was facing immediate closure due to a “shelter-in-place” order and possible case of COVID-19 on site. Such open-ended closure would have crippled the agency’s finances and sent key staff searching for new positions elsewhere, while leaving more than 30 acutely ill psychiatric patients without the treatment they need.

Partial Hospitalization Program (PHP) is a well-established day treatment modality that provides six hours of structured therapeutic activity five days a week. La Cheim’s PHP is known for being exceptionally compassionate, non-institutional, and gender-aware care for adults coping with serious mental illness. As such, sudden program closure, while other mental health agencies were similarly curtailing their operations, would have left many acutely depressed and suicidal patients “on the street” with limited or no access to desperately needed services.

At first, the idea of transforming the program into a fully virtual format seemed non-viable, even farcical, due to many factors – lack of software, hardware, budget, time, employee anxiousness about technology, and extreme skepticism from insurers who doubted the community-based element of PHP treatment could be credibly replicated online. There were two of us with technical expertise: myself, a health I.T. professional with a medical degree, and a Doctor of Psychology with prior IT experience.

At La Cheim, we were also quite skeptical about video conferencing, since group therapy sessions are the core component of Partial Hospitalization care. However, someone came up with an excellent idea to call our patients and just ask what they think. The feedback has been surprising - over 90% of clients not only wanted to participate in a virtual PHP program, but were also enthusiastic about it.

And insurers soon followed suit. In light of the pandemic, Kaiser Permanente, Cigna, and other major insurers in the area made rapid and compassionate changes to long-standing policies, opening the way for tele-PHP (which would have been unthinkable a week prior).

Those approvals came after the agency had to shut its doors on Friday, March 13. Saturday, March 14 was Day One for us – despite a lack of insurance approvals, a staff and patient census terrified by COVID-19, and the seemingly impossible mountain of work that lay ahead, we began crafting a tele-PHP plan early that morning – hoping against hope that it may turn out to be more than just a techie’s daydream.

Days Two-Five: Preparing Infrastructure while Missing Sleep

Any major task may look intimidating at first, but once you start cutting it into bite-sized chunks, it all of sudden becomes reasonable to execute – provided you’re comfortable with working 18-hour days 7 days a week for weeks on end. We broke the key tasks into 4 major categories: communications, compliance, clinical tools, and reporting. We then went over all categories and determined core components necessary to create -- pardon my Silicon Valley lingo – a “Minimally Viable Product (MVP)” – hoping, of course, that it may also become a “Most Valuable Player (MVP)” – but only time would tell.

Key infrastructure concerns that needed to be addressed in real time were:

  • HIPAA-compliant video-conferencing platform;
  • Updated consent forms that cover tele-care;
  • Remote access to office phone lines;
  • Staff and patient training.

To minimize the number of “technical hotspots,” we decided to keep existing solutions whenever possible, even if built-in features were suboptimal. For example, we kept our existing cloud-based EMR with no tele-care functionality. As we were readying for launch on Tuesday, March 17 - a day before the Office of Civil Rights (OCR) announced that they are relaxing the privacy rules ( - we had only been looking at HIPAA-compliant vendors that offer Business Associate Agreement (BAA). The newly relaxed privacy rules enabled us to move forward with-our preferred video conferencing platform without a BAA – important, as this platform was emerging as the clear video platform of choice for Bay Area mental health.

Access to the office phone system has been a breeze, as our existing telephone provider already supported VOIP calling via an iOS and Android app. This enabled our providers to immediately resume calling patients using a softphone app on their smartphones.

Finally, to wrap up the informed consent and privacy piece, we realized that patients dislike HIPAA consent forms and find them confusing. We decided to maximize transparency and user-friendliness by creating a tele-medicine consent form that every patient could understand. The challenge was to explain to patients that their personal health information still remains as protected as if they were seen in the office setting.

The only exception to this privacy standard involves certain program information being transmitted via non-encrypted email (a relaxed privacy standard that immediately became a requirement for tele-treatment to maximize efficiency while sparing clients the frustration of dealing with confusing message encryption). This was a choice we made in the spirit of OCR’s relaxed regulations – prioritizing patient access to care over the field’s traditional avoidance of email for HIPAA compliance.

Creating a Tele-PHP may seem like a difficult task. The reality is that most building blocks are already there – and the clinical demand is certainly there. Part two of this story will cover the launch day and the aftermath.  Please stay tuned.

By Charmydevine Beane, HIMSS NorCal Membership Chair

Implementing an Electronic Health Record (EHR) involves diligent planning across multiple phases, from pre-work to post-live. One of the key phases in the EHR implementation process is training. At a high level, the training phase will encompass training all end users on the system, hands-on system practice and personalization. The best practices outlined here include applications from many healthcare delivery organizations across the United States with varying size, scope and complexity.

Here are the nine key areas to keep in mind.

Training Approach and Roles and Responsibility: Offer a variety of workflow-based/role-based training modalities with hands-on practice and with considerable support. Similarly, the training team will perform a variety of key roles, from curriculum development to training environment maintenance; therefore, it is necessary to define clear delineation of roles and responsibilities.

Training Timeline: Training delivery should begin five to six months prior to go-live, beginning with the publishing of the training schedule. In general, Super Users are trained first, as they will support future end-user training.

Identifying Trainers and Proficiency Requirements: Not all trainers are created equal. Leverage existing trainers, as they might be ideal candidates. Look for experts at neighboring organizations who may have also recently implemented an EHR. Trainers are also required to demonstrate proficiency for teaching the system, so consider a train-the-trainer (TTT) program where graduates must pass a content exam and complete a peer training assessment.

Training Content and Curriculum: Work with the Training Manager, CMIO, leadership stakeholders, and physician leadership to determine training tracks and curriculum. It is also important to update and communicate existing policies and procedures prior to go-live, so they reflect and support new system workflow. Facilitate pilot training classes with build analysts and operational leaders to validate curriculum content, training structure, and appropriate system access.

Physician Training: Work with the training manager to ensure there is a physician training strategy in place. Utilize physician champions as trainers based upon their knowledge of and enthusiasm for the system. Consider specialty physician training that ensures the content is reflective of their specific needs and encourages faster adoption of the system. Be prepared to address resistance to in-class training and work to determine how to address these physicians and their individual concerns. The timing of physician training also differs from the recommended end-user training timeline. Consider training physicians within two to four weeks prior to go-live.

No Training, No Access: Require training and end-user competency for system access and establish a policy for end users who do not meet the requirements.

Training Management and Tracking: It is critical to establish a system for managing, scheduling and tracking end-user training status. Very early on, it is important to:

  • Identify the learning management system (LMS) that will be used to schedule end-user training.
  • Determine the number of end users who need training.
  • Develop a process to manage current and future end users who need training.

Training Sessions: A successful training session is well-organized. Here are some logistical considerations to keep in mind.

  • Ideal classroom size is eight to 16 end users, led by a training and supported by a Super User.
  • Accommodate various schedules, including first, second, third and weekend shifts. Some training may be offered 24 hours a day, seven days a week, or at a minimum of 7 a.m. to midnight.
  • Utilize a centralized training location.
  • Treat physician training much like the organization's credentialing process. Work with the Medication Education Department to certify the training curriculum
  • Fill classes with like providers of the same specialty (e.g., ED providers).

Backfill Coverage for Training Participants: Start backfill-coverage planning a year prior to go-live to account for shift scheduling. Ensure Champions and Super Users are relieved of operational duties to attend training, support training and complete go-live support shifts.

The goal of an EHR implementation training program is to ensure all end users complete the prescribed training and reach the required competency level prior to being granted system access. However, one size does not fit all. It is important to develop a training program based upon the unique needs of the client and scope of the EHR implementation.

Original Publication: Impact Insights

​​​​​​​By Charmydevine Beane, HIMSS NorCal Membership Chair

Effective communication is key to the success of any initiative, whether that is implementing process improvements or rolling out a new information technology or system. The purpose of the Communications Plan is to lay out the framework, messages and tools for effective communications that support your project objectives.

Your project team should have resources dedicated to the development and execution of your Communications Plan. Typically, a Communications Strategist is responsible for leading this effort. However, this person will need to collaborate with multiple departments and various levels of leadership to overcome the challenges of creating a comprehensive and effective Communications Plan. Initially, you might be faced with difficulty identifying the right people and the right information, although once you have the appropriate team in place, you have what you need to get started.

Don’t forget these 4 points!

Here are four important things to remember when developing a Communications Plan:

  • Find out if your organization has an existing Communications Strategy and/or executable Communications Plan. Do some analysis to determine the maturity of the model. You might find that there is a strategy or plan in place, but it lacks the finer details of execution.
  • Leverage the existing Communication Plan, if possible. This improves buy-in and encourages collaboration. Begin with an analysis of the plan and identify areas where there are gaps.
  • Learn what role the Marketing Department has in Program Communications. You’ll want to understand their policies and previous approaches. You also don’t want to “reinvent the wheel.”
  • Learn about the organization’s appetite for communications. Do employees experience “communications fatigue” or are they highly engaged and responsive to program communications. Leverage existing channels and embed your project’s messages to help prevent fatigue.

As with any good communication, the flow of conversation goes both ways. Effective project/program communication not only pushes important information out project-wide (and sometimes system-wide), it also pulls in feedback and allows you take the pulse of the entire program.

Effective communication requires a constant feedback loop, which supports the awareness, understanding, commitment and appropriate actions of your audience. Two-way communication also ensures your Communications Plan will meet the needs of the program.

Original Publication: Impact Insights


By Charmydevine Beane, HIMSS NorCal Membership Chair

While a communications program that covers multiple hospitals and clinics may seem overwhelming, it does not have to be.

The key to using your system’s complex structure to your advantage is to leverage communication tools, key program and facility leadership, and established venues to make your communications program more efficient. Here are four things you can do to leverage the existing channels to support the operationalization of your multi-hospital communications program.

One Communication, Many Uses

Some communications require targeting one particular audience such as providers, while other communications – like go-live readiness – are general messages applicable across the system. You can develop messages that can be used to communicate to providers at a system level (all facilities) and then customize that same message for additional use in hospital departments and specialty clinics. Leveraging the same communication for multiple needs will save you time making your program much more efficient.

Leadership Meetings: Combine, Divide & Conquer

When a system encompasses multiple facilities, your leadership meetings may be scheduled at different times and locations but ultimately need consistent messages and program updates. Determine if combining meetings at one location is possible, and if so, be sure to consider proximity and meeting space capacity. Remember to leverage facility-specific communications for use at other facilities when needed.

Leadership Meetings: Teleconference Options

One variation of combining leadership meetings is to arrange video or teleconferencing participation at separate facilities to minimize travel. If possible, have one program leader present at each facility to engage with the hospital leadership and maintain relationships.

Program Update Communications

Even when communicated content varies, the standard update should have a similar format across the program. Leverage templates and graphics that have been established for other projects such as timelines, charts and other status reporting tools, then customize them to meet your program’s needs. Meet with your marketing and communications representatives from each facility to standardize templates and messaging across the system.

The bottom line is, you don’t have to reinvent the wheel. Leverage existing resources and tools to develop and successfully launch your multi-faceted communications program.

Original Publication: Impact Insights 

By Jenni Bendfeldt, Founder and CEO, RecastHealth; President-Elect Northern California Chapter of HIMSS

In April our chapter hosted the annual ePatient Summit with a focus on how social determiants of health impact care outcomes. During this event a group of panelists presented a case study on how they were able to address patient access and transportation issues through innovative partnerships.

Panelists included Sheila Lyzwa, VP of Care Coordination for Alameda Health System; Thomishia Booker, Manager of Care Management, Alameda Health System; Steve Grau, Founder & CEO of Royal Ambulance; and Dan Trigub, Head of Uber Health. The session was facilitated by John Sharp, Director, Thought Advisory for Personal Connected Health Alliance.

This presentation led to the creation of a thought leadership piece that was published as a blog on HIMSS National. Our chapter is incredibly honored to be able to promote such exciting advances in healthcare taking place right here at home and we invite you to read the article here: Removing Patient Transport Barriers with Innovative Partnerships.

If you are interested in presenting your own story of how innovative partnerships have made an impact on patient outcomes, please reach out to us. We are always looking for conference speakers or contributors to our chapter blog. Email for more information.

This post represents a deep dive into how trust between different parties affects healthcare systems integration, dovetailing off of an initial Twitter thread.*nGq-QjDeNfzuKbyi.jpg

Nope, not creepy at all.

Integration and interoperability are mission-critical to many companies and applications in the healthcare space. The advent of the electronic health record (EHR) has created data hubs around which all other applications orbit, dependent on that focal point as a planet is with the sun. Connecting to this data is an important part of the strategy for any company looking to sell in the healthcare space.

Much time and effort have been spent describing and trying to understand the content standards and transport technologies used to connect to EHRs (case in point, one of the most popular articles I’ve written was on the history of healthcare standards for Redox). Far more fundamental and even less understood by the average healthcare company, though, are the trust paradigms that underpin all methods of exchange.

Broadly speaking, healthcare has three main trust paradigms that define exchange, each having their own set of benefits and drawbacks. Healthcare tech companies too often limit their thinking to one model or, worse, spend valuable time/effort trying to integrate using a model inappropriate to their use cases. Here’s a brief overview:*lE3UgbHMQIs6s7lNQ99fRQ.png*OdCVeBa-zJIy1gN--0UqSA.jpeg

Agreements and contract for each institution. Get your pen ready.


Business Associate Agreements (BAA)

So what is this first line? In another name, it’s just traditional interfacing (also known as edge system interfacing). By this paradigm, companies make an application and sell it to health systems. These companies scale by selling to lots of health systems, one-by-one, so having a mature marketing and sales pipeline is mission critical. What if you’re a consumer or payer facing application? In this model, you’re going to have fun, as you’ll still have to make healthcare organization (HCO) agreements one-by-one.

What exactly are these agreements (BAAs) anyway? Luckily, our friends at the University of Southern Florida have a pretty good explanation:

A HIPAA BAA is entered into typically by an outside consultant who provides a service to a medical organization. In many cases, that is an individual or business that works in health IT, and may represent a service subcontracted out by healthcare organizations such as hospitals and physician clinics.

As defined by the federal government, a business associate is any person or entity that performs healthcare record services for an insured medical provider, but is not a member of the workforce of the covered entity.

These services involve access to healthcare records protected under HIPAA. The guidelines in HIPAA require that covered entities — a hospital, for instance — must enter into a contract with business associates.

The goal is to ensure that any business associate uses health information in a secure, safe manner and that patient information is not illegally disclosed or used.

In short, each healthcare organization still needs to agree to allow your app into their ecosystem before their providers can use it or before your application can start interacting with the HCO’s data. In order to be successful with this paradigm, applications must clearly articulate their value proposition for the healthcare organization, demonstrate the security of their product/platform to the healthcare organization’s standards, and find key stakeholders within the organization to propel the application’s use case forward. In other words, applications should ensure they have a mature, effective B2B marketing and sales team, as they’ll need to convince organizations and not individuals of their value one-by-one.

Traditional interfacing has a lot of different input/outputs. Health Level 7 version 2 (HL7v2), dominates the scene and is by far the most prevalent. However, applications should be ready for EHR vendor APIs (Application Programming Interface) — especially when dealing with Athena or Allscripts, flat files (older EHRs), and Fast Healthcare Interoperability Resources (FHIR). If the application’s workflow leans towards financials or imaging, X12 and DICOM are also still possibilities. Once you get past those hurdles, though, traditional interfacing has some benefits. You can read and write all sorts of data, allowing applications to build deep, embedded workflows.


  1. Depth of data exchange: Once you’ve been allowed in, the sky is the limit (where the sky is the EHR’s inventory of interfaces, APIs, and other import/export mechanisms). This will vary by the complexity of the EHR and also the type of health system.


  1. Legacy scattered technologies: The history of healthcare technology is a battlefield littered with the wreckage of well-intended “universal” standards and vendor-specific formats. An application intending to scale must be equipped to handle a never-ending onslaught of new formats, files, and functions to understand and process.
  2. Variable capabilities across EHRs: The potential of this trust paradigm is only outweighed by its variability across EHRs. Even when just deploying across HCOs of a single EHR, factors like deployment strategy, cost, and technical preferences mean that integration strategies that were previously successful may differ at a new site. Sending in a message to create a patient, for instance, may be acceptable for some, but a mortal sin at other sites.
  3. Myriad IT and change control processes of hospitals: IT divisions of HCOs have been trained for 40+ years that integration is hard, third parties are scary, and mistakes can be career threatening. As a result, there’s a visceral Pavlovian negative response to new integration projects, even as newer standards (FHIR and APIs) and methodologies (app stores/ecosystems) decrease the tech barrier. Expect that hospital organizations’ change control processes and ability to find ways to say no will be the bane of your existence (assuming that you are able to overcome challenges 1 and 2).
  4. Slow scaling across organizations: Given the problems above, it becomes a herculean effort to try to deploy and integrate at one healthcare organization, let alone many. For applications whose main use cases depend on broad data aggregation or amalgamation, such as patient applications, payor applications, clinical trials, or analytics companies, this trust paradigm is simply not an efficient route to the scale of data needed for success.*BKqMyxEllvgcVyzHX06jXw.jpeg

One agreement with wide-ranging access

Trusted Networks

Okay, so now we’re onto line two in the diagram, aka the trust paradigm of the 2000s. In that decade, trust networks such as Carequality, CommonWell, DirectTrust and regional health information exchanges (HIEs) were created and began to offer a simpler scaling path than line 1. Trusted networks are just that: follow the defined rules of the network of organizations (rules of trust) and gain access to large swaths of HCOs (networks) at once. This was the dawn of Enterprise Interoperability, the exchange of data between healthcare institutions.

Understandably, this form of trust is quite a step forward. Applications could now reach lots of providers without signing agreement after agreement. Large datasets were accessible, giving a cross-organizational view previously unthinkable. Data could be pulled through Carequality, CommonWell, and HIEs. In terms of writing, applications could push back through DirectTrust or (for some prescriber/pharmacy interactions) Surescripts.

As for tech, Integrating the Healthcare Enterprise (IHE) Cross-Enterprise Document Sharing (XDS) is the most common transport standard for pulling data, Direct is the nationwide transport for push and Consolidated-Clinical Document Architecture (C-CDA) is the content format that acts as a patient snapshot and includes medications, allergies, and problems. Some of the networks dabble in HL7v2 (retro) or FHIR (trendy).


  1. Large general datasets from across the nation: A C-CDA is an inherently data rich method of exchange. Although it’s essentially the only content standard in use in this domain, it’s at least a pretty good one when measured by the number of use cases it can service.
  2. Simpler access: Compared with BAAs, this allows a much wider breadth of access with a simpler overall process. Sign an agreement, perhaps go through a certification process, and suddenly have the ability to pull or push data from millions of patients across the US.


The networks aren’t perfect. As it stands, several aspects of their current state and history limit their efficacy:

  1. Comprehensiveness of network: Each trusted network is incomplete, in that none have 100% deployment across their user base (generally providers). Some are close, such as Surescripts for the prescription use case, but it’s worth knowing that these networks are partial.
  2. Comprehensiveness of data: As mentioned before, the primary data exchanged across most trusted networks (outside of Surescripts) is the C-CDA. This focuses on the core patient data needed for the transfer of care, so use cases requiring specialty data are not well supported (such as oncology or obstetrics). Additionally, the quality of data within that structure is highly variable, in that some EHR vendors have highly structured, discrete C-CDA content and others have more or less mailed it in and done the bare minimum necessary for federal regulations from Meaningful Use.
  3. Legacy technologies: In contrast to the technologies of BAA trust domain, trusted networks are more consolidated around a defined and well-known set of standards and technologies. However, trusted networks are derived from complex, slightly dated technologies. There’s a solid tweetstorm here about it, but old, obsolete tech contributes strongly to points 1 and 2 above. Adoption is harder, so the comprehensiveness of networks improves more slowly. Similarly, overly complex content standards with arcane rules mean it’s simply harder for vendors to deliver consistently.
  4. Purpose of use: Trusted networks are limited in use case (purpose of use). Organizations freely exchange patient data for treatment (and functional equivalents), but payment, research, patient release, and operations are still stuck in the stone ages, using direct hospital agreements as their primary trust paradigm.*jxKpcVK2JqrXh1VwTZo-0Q.png*xu0MD6dw4syoJOKH3cHeDA.png

Lots of use cases. Not many supported.

5. Ability to push or write data: Not many of the trusted networks are servicing “write” workflows. Most are built around querying workflows. Direct offers the ability to send authenticated, encrypted health information directly to known, trusted recipients over the Internet, but it’s essentially just email with a C-CDA attached. The information is usually received into an email-like client within the EHR or (worse) a third party viewer not directly connected to the patient record. Trusted networks still have a lot of work to do in terms of facilitating the push of data to EHRs, particularly for use cases like referrals or scheduling.*on4YEBEhiTTr2H2aIevyqg.jpeg

Patient Authorization

Line 3 is very new but decidedly exciting. In terms of how it works, by using a patient’s log-in credentials, applications can pull the data roughly equivalent to a C-CDA, known as the Common Clinical Data Set (CCDS). It’s not so different from line 2 in terms of content, but with modern tech, it’s suddenly more reliable and easy to connect.

@Apple’s Health Records is the biggest player using this trust paradigm (given it’s on every iPhone), but also one of the best, as they do this just about as well as it can be done right now. If you own an iPhone, you can go and jump in there to get a picture of how patient authorization works. If not, there are a number of alternatives, such as CarePassport, myFHR, or Coral Health.

SMART on FHIR (Substitutable Medical Applications, Reusable Technologies) is the technology framework that enables this model. It relies on OpenID Connect, which many consumers are familiar with from their day-to-day Internet explorations across websites and applications using Google, Facebook or another provider as a central log-in source of truth. It’s huge for the industry, opening up an entirely new class of trust that enables patients as active participants. For this reason, it wouldn’t be hard to argue that SMART is as large of a step forward as FHIR is itself. Without SMART creating a new trust paradigm, FHIR is simply a new technology littering the landscape of BAA world.

It’s worth noting that patient authorization cannibalizes the market for some use cases in trusted networks. Personal health records (PHRs) that previously may have needed to pay to join Carequality and Commonwell have viable paths to access data for free. However, as long as patient authorization has the limitations listed above (data set, patient portal usage, etc), the two approaches are still somewhat complementary. Additionally, for scenarios where the patient isn’t authorizing (like provider to provider messaging), direct trust networks are still an important piece of the overall integration puzzle.


  1. Blowing the doors open for patients as participants: This trust paradigm simply changes the game for patients. Previously shackled to a healthcare organization’s patient portal (or worse, paper, in the event no patient portal is offered), this paradigm has propelled forward an era of equal opportunity in the PHR space, spurring innovation by leveling the integration playing field. However limited that might be currently (see below), it’s still a massive step forward for patients to have freedom of choice in terms of an application that can pull their records.
  2. Large general datasets from across the nation: The CCDS is an inherently data-rich method of exchange (although slightly less so than C-CDA). So it’s not a bad place to start for this newborn trust paradigm.


There are a couple of limitations, though:

  1. Patient as the user: It’s reliant on patient credentials, so it’s really only useful if you’re building a consumer-facing application. Note that this is not so much a flaw to be fixed as a fact of the paradigm.
  2. EHR support: It’s still not fully supported across EHRs. Only a handful of the government mandated patient APIs are in the FHIR format(178 out of 330 certified EHRs, per ONC). Only a fraction of those actually offer full, open SMART on FHIR. Lastly, for some EHR vendors, you still need to sign agreements/get enabled at the HCO level (line 1 of our trust matrix). A safe assumption right now is that if you’re doing this method, you’re more or less only getting Epic sites.
  3. Patient portal reliance: Patient portal usage is necessary (in that a patient must have log-in credentials to authorize the release of their data). If they don’t, you’re joining trust networks or signing BAAs.
  4. Comprehensiveness of data: The data that’s accessible is the CCDS. If you want anything beyond that, such as images, documents, advanced vitals, specialty-specific data, etc, you’re out of luck. As you can imagine, back to BAA world you go.
  5. Ability to push or write data: There are no write capabilities, as it stands. The application must utilize Direct (a trusted network that has limited abilities to push back to a broad network of HCOs) or direct BAAs in order to facilitate that sort of exchange.*WpyeKpDfPIiMNTTiHejsmw.png


Beyond the current state of healthcare trust paradigms, it’s also worth examining how we (patients, providers, vendors, and regulators) can improve the state of each paradigm to build better healthcare outcomes.


In general, the world of BAAs will continue to be the most important route for most new applications in the healthcare space for the foreseeable future. In contrast to the other areas, the impact of upcoming legislation (ONC Cures and TEFCA) don’t directly affect this trust paradigm. However, a couple of emergent strategies and trends come to mind as important:

  1. A shift of responsibility from HCOs to EHR vendors for application security and privacy: App ecosystems are popping up with each EHR vendor. In this model, applications can register, build, test and even be certified by EHR vendors in advance of selling to healthcare systems. Previously, this all occurred live in implementation after selling to an HCO, so applications can frontload their efforts. Perhaps more importantly, though, the vetting of applications by EHRs potentially means that partial trust is established earlier, allowing for quicker contracting of their BAAs with HCOs.
  2. Consolidation of disparate technologies around FHIR: The disparate technologies of yesterday are slowly being supplanted by SMART on FHIR. Given that a SMART on FHIR is generally faster and easier than a traditional HL7v2 implementation, this is a positive shift. The pace of this consolidation across vendors and healthcare organizations will be an important trend to watch.
  3. A change in mindset within HCOs: Unfortunately, even though SMART on FHIR for providers lowers the overall technical barrier, its trust paradigm is still built upon a BAA, as it stands, which is for most healthcare organizations still a nightmarish ordeal. Innovative healthcare organizations, however, are recognizing the change that app ecosystems and SMART on FHIR offer. They are spinning up digital health programs, oftentimes with lighter weight security and change management than their traditional IT governance structures, to allow quicker innovation.

Trusted Networks

Trusted Exchange Framework and Common Agreement (TEFCA) is coming legislation and promises to shake up the trusted networks model. With our national interoperability network currently somewhat disjointed on the whole, with various partially connected hubs and webs, the legislation will work to simplify access and connect the disparate parts.

TEFCA will … “establish a single on-ramp for HIE that will enable providers, hospitals and other healthcare stakeholders to join any health information network (HIN) and then to automatically connect and participate in nationwide health information exchange.”

In that light, we can review how TEFCA affects the problems of trusted networks listed above.

  1. Comprehensiveness of network: This is a primary goal of the legislation and it promises to help drastically in this regard by unifying disparate networks, making a cohesive network of networks. While everyone agrees on this outcome, some dispute ONC’s approach here. Personally, I’m for it.
  2. Comprehensiveness of data: TEFCA doesn’t really make any moves to address this, per se. Content is not a focus and the legislation seems to just solidify C-CDA exchange, so efforts to improve the situation will have to come from the private sector.
  3. Legacy technologies: TEFCA keeps the existing legacy technologies such as IHE XCA, XCPD, and XCDR in place as the primary (required) standards, but listed new technologies like FHIR as alternatives. Pundits around the industry debate the correct approach here (“if it ain’t broke, don’t fix it” vs “one standard to rule them all”). I’ll shy away from that debate and say that the existing networks are robust, but that it would be nice to see a clear transition plan to modern technologies.*C8pgmZzVaECKtSbA1OZgkg.png

4. Purpose of use: TEFCA expands on the permitted purposes of use quite drastically, which should be beneficial most immediately to payers.

  • Treatment
  • Quality Assessment and Improvement
  • Business Planning and Development
  • Utilization Review
  • Public Health
  • Benefits Determination
  • Individual Access Services

Outside of Individual Access Services, reasonable fees may apply for these new use cases, however. As a result, it will be interesting to see how new players and use cases are added to the existing networks. Given the history here, I wouldn’t expect all the networks to suddenly open up to previously underserved purposes of use, but I am hopeful for innovative networks to lead the charge (as Commonwell is now doing for patient Release of Information).

5. Ability to push or write data: TEFCA calls out the need to be able to push data across its network, but doesn’t explicitly expand on existing use cases in a major way. As a result, it’s not likely that we see a major expansion (like FHIR within Direct) supported by EHRs in the near term.

Patient Authorization

ONC’s recent Cures NPRM is generally aimed at this trust paradigm. For patient authorization, clearly, the push has to be towards fixing the aforementioned flaws, so it’s worth assessing how the legislation tackles each problem.

  1. Consumer-facing only: As noted before, this is a fact of the paradigm.
  2. EHR support: ONC tackles this head on, but only for certified EHR technologies. OpenID Connect + SMART are written into the rule, so after the rule becomes law, we’ll see vendors shift from the random assortment of MU3 patient APIs towards SMART on FHIR. Availability of data should continue to increase from the roughly 300 or so institutions now offering SMART on FHIR to a much higher percentage of US healthcare organizations.
  3. Patient portal adoption: Patients need to be further incentivized to create and use patient portals. New consumer-facing applications will play into this (given they rely on those log-ins, they incentivize patients to create and maintain them), but ultimately, HCOs need to be proactive in pushing use.
  4. CCDS: The good news is that the new USCDI is more comprehensive than the CCDS. However, unless it changes, it’s still missing important data, as it really only added clinical notes. Giving patients access to images, advanced vitals, or specialty data like oncology staging would move the needle on patient authorized applications towards truly impactful.
  5. Write capabilities: The legislation stays away from this with a ten-foot pole. Future legislation will be needed, as HCOs and EHRs will be very hesitant to open their systems in that way without some pushing. For the foreseeable future, write capabilities will entail using Direct (a very rudimentary write, in that it only allows for essentially secure email with at best a C-CDA) or utilizing direct agreements with hospitals through BAAs.

Other Trust Frameworks?

It’s worth considering if there are other possibilities in the future in terms of how we conceptualize trust in healthcare exchange. One possibility would be pure provider authorization, where each individual provider user could choose and launch an application for their own use using their credentials, similar to patient authorization. In this paradigm, SMART on FHIR would work seamlessly for providers and there wouldn’t be the current overhead of a prerequisite BAA with the hospital.

Some major changes would be needed, though. One possibility is that EHRs or another centralized party would take on full responsibility of vetting, certifying, and approving applications before they’re released into this paradigm, taking on responsibility for ensuring the functionality, security, and privacy of the apps. It’s hard to imagine HCOs trusting the EHRs to do this fully, though, so I’d imagine the only way this occurs is if there’s a policy push at a state or national level.

Beyond that, this author struggles to envision other trust paradigms, but I’m always open to hearing your thoughts or ideas, so please reach out!

EDIT: Grahame brought up the idea of government as a possible trust entity, which is in line with the pure provider authorization, in that government could act as the verifying and registering body for applications in certain countries. When writing above, I was thinking more of private industry (which is why I said “EHR vendors or another centralized party”) fulfilling that role, most likely due to my US-minded brain discounting the government taking on that responsibility domestically. However, government is about as centralized as it gets, so for countries willing to take that plunge, it’s well-suited to provide the necessary pre-requisite services for pure provider authorization.

Another piece I missed is the natural evolution from patient portal credentialing towards a single authorization for a patient. The CARIN Alliance is doing the work there towards a future where a patient uses a single, trusted log-in to access their data across all EHRs. It’ll likely take legislation to force EHR vendors to accept this third party authentication rather than the patient portal credentials they maintain, though.

What it means when you’re developing

So those are the three paradigms. As you’re building digital health applications (or anything that needs healthcare data), consider all three. Combining them can be your differentiator.

Applications for patients

If I’m direct to patient, I’m starting with the third. Consumers are used to logging in with Open ID from their day-to-day Internet activities. However, the patient authorization space is crowded to the point of saturation. As a result, what’s so interesting is that the no-friction, open access means all players are doing up to the limit of what’s possible. Patient authorized data has been completely commoditized. In short, what Apple Health is doing is really almost identical to what 1up Health,, myFHR, or any number of other patient authorized access players are doing in the space. There’s simply an upper bound on what’s possible. Any new legislation will continue to open up what’s possible, but applications will quickly hit that ceiling. Therefore, new consumer applications will have to rely on novel visualizations, advanced analytics, and integrations with different data sources (that have more inherent friction) to differentiate.

Thus, as a direct to patient application, once you’ve hit the ceiling, it makes sense to combine patient authorization with deeper integration strategies. Joining trusted networks may make sense, depending on what purpose of use you have. Eventually, at some level, your needs will dictate you’re probably going to want to think about BAAs.

Applications for Providers (or other HCO users)

Provider apps should start with BAAs. It’s necessary to understand the process there and adapt to it. App programs from EHR vendors (or other vendors like Redox) can drastically accelerate your deployment, although you’ll still need to market, sell, and sign agreements to hospitals (a.k.a. you still have to hustle).

The other methods may be able to supplement your approach, depending on what workflows you’re servicing. In general, if you’re making primary software for an entire organization (EHR, reference lab, pharmacy, LTPAC, social care, or any other organization providing treatment), it’s worthwhile to get your enterprise interoperability strategy sorted.

Other Applications

If you’re not aimed at patients or HCO users, you’re likely talking about payers or pharma. In that case, you’re locked out of most direct trust networks at this time. Assessing your workflow and use case is valuable, as there may be certain networks, especially at the regional level, that could be a fit. It may also be viable to use patients’ authorization to get the data you want, despite the limitations across EHR vendors currently. However, it’s most likely you’ll need to approach it from a BAA perspective, so firming up your value proposition for HCOs is important. You may be able to leverage a close relationship with an EHR (through an app program or through a partnership) into accelerating this process.

The Plug

Hopefully, this walkthrough was helpful when considering integration within healthcare from a trust paradigm perspective. As you look at building your connections yourself, buying a solution, or working with a partner, consider Redox. We’re one of the few interoperability vendors that actually span all three trust paradigms and we’re industry leading in navigating the most difficult (the world of BAAs). At the very least, I guarantee we’re fun to talk to.

Let me know through the comments your general thoughts. For more in-depth discussions, feel free to reach out via email at or Also, let me know if you see any glaring errors and I’ll fix them!

Brendan Keeler

HIMSS19 in Orlando

By Jenni Bendfeldt, Secretary, Founder & CEO of RecastHealth

Along with over 43,000 attendees, several members of the NorCal chapter attended HIMSS19, the largest health IT conference of the year. This year’s event took place February 11-15 at the Orange County Convention Center in Orlando and kicked off by announcing what some may consider to be the most impactful piece of proposed legislation for healthcare interoperability and data-blocking yet, the 21st Century Cures Act.

Throughout the week, the convention center buzzed over what these proposed changes could mean for health IT vendors and healthcare executives, as well as patients. In short—the powerhouses that have dominated the industry for the last decade (e.g., EHR vendors, major health systems) will now be obligated to play nice with their competition for the purposes of coordinating patient care and ensure patients have easy access to their health information at no cost. 

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CalHIPSO Partnership

HIMSS NorCal Chapter is pleased to announce our collaboration with CalHIPSO, a non-profit organization providing technical support for California safety net providers. Beginning in 2010, CalHIPSO provided over 10,000 providers from FQHCs, small practices, and public hospitals to improve operations and access to federal incentives, most notably around programs such as Meaningful Use and MACRA/MIPS (QPPSURS program). This partnership will give HiMSS NorCal better insight into the challenges these organizations face and the opportunity to improve outcomes through the use of technology.

CalHIPSO also provides educational events and we encourage our members to register:

Monday, May 13th, 2019 - First Annual CalHIPSO Conference: Health IT, After Meaningful Use (Sacramento). This exciting one-day event features nationally-recognized speakers on payment reform, medical-dental integration, and state and federal HIT policy. Early Bird registration runs through March 15th. Register here:

Call for Nominees

Beginning, April 1, 2019, the HIMSS Northern California Chapter is accepting the nomination of candidates for the following positions on our volunteer Board of Directors for the next fiscal year beginning July 1: 

What positions are available? 

Executive Committee 

  • President-Elect (3-year term)
  • Secretary (2-year term)
  • Treasurer (2-year term)

Committee Chairs 

  • Membership Committee Chair
  • Programs Committee Chair
  • Sponsorship Committee Chair
  • Advocacy Committee Co-Chair

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Upcoming Annual Conferences 

If you would like to sponsor one of these events, please contact   

ePatient Summit 2019

April 25, 2019 | 11:30am-6:30pm
Salesforce East
350 Mission St. 
San Francisco, CA 

Beyond Brick and Mortar: Busting Down the Barriers to Healthcare
This year’s summit will provide a platform to exchange ideas. We will explore the exciting ways that technology is changing the way that patients can receive care and interact with their care team. From real-world case studies, you will learn about different ways care providers are getting a more holistic picture of their patients through the Social Determinants of Health, how technology is enabling patients to receive care anywhere, and how new technologies like voice, chatbots, and mobile apps are upending the traditional constraints of healthcare.


7th Annual Innovation Conference & Showcase

June 13, 2019 | 9:00am-6:00pm
International Technical University
2711 North 1st St. 
San Jose, CA

API Studio - Connect, Unlock, Plug-and-Play
The digital revolution spawned by consumer apps is taking off in healthcare. And the need to make health data accessible, useful, and friendly to patients and clinicians has become a national priority. Healthcare APIs fueling this paradigm shift are rapidly finding regulatory and market commitment. Our industry is demanding openness and preparing to rally behind the players who advance it. 

Is your hospital ready to meet this demand? Is your platform truly developer friendly? Is your code good enough to make healthcare work as it should? 

We’re bringing the best developers and innovators across vendors, entrepreneurs, and health organizations in Northern California and beyond to API Studio to collaborate and to disrupt the industry at scale. Join us to see how health tech's brightest minds and best innovators build their APIs. Take away tools and top tactics that you’ll need to succeed in the app economy. Learn how to build awesome tech that drives high-value interactions for your patients and partners. 
Come innovate in the open. Let’s Connect, Unlock, and Plug & Play! 

Spotlight: Jenni Bendfeldt, Secretary HIMSS NorCal, Founder & CEO of RecastHealth

Many of our members have founded companies to help drive healthcare IT innovation further, including our chapter Secretary, Jenni Bendfeldt. Jenni has been a member of the NorCal HIMSS board since 2015, and has served as Chair of the Membership Committee, introducing analytics and reporting process to drive decision-making, and contributing to a number of educational programs. In January 2019, Jenni took on a new venture as Founder & CEO of RecastHealth, a consulting company that works with digital health startups. Recognized as one of Becker’s Healthcare’s list of Rising Stars: Top 90 Healthcare leaders under 40, Jenni has spent over a decade in healthcare in a variety of roles (e.g., clinical nutritionist, practice administrator, IT director, project manager). Prior to founding RecastHealth, Jenni spent 6 years as a consultant with ECG, where she led numerous high-profile projects for large health systems across the country. She says, “Being in the Bay area, I’ve watched too many great startups struggle when deploying their solutions. This wasn’t because of poor technology or a miscalculated opportunity, but because they did not understand the fundamental differences between healthcare and other industries. I founded RecastHealth to help make sure these companies did not have to learn the nuances of the industry the hard way.” Jenni is also a recurring lecturer at Berkeley’s DeCal Future of Healthcare class, has published several articles related to digital health innovations and regularly presents her insights on the evolving healthcare technology space to audiences across the US. 

Get Involved with the Chapter!

Want to help plan one of our annual programs or join a committee? Volunteering for our fabulous events or getting involved with program planning, communications and sponsorship are great ways to expand your professional network and advance your career. It's fun, too! 

If interested, please complete our volunteer survey to get started:

Jason Johnson, CISSP, PMP, FHIMSS

President-Elect, HIMSS Northern CA
Information Security Officer, Marin General Hospital

March 2019

Maybe it’s just the algorithms that program my news feed, but hate is abounding towards this year’s RSA Conference in San Francisco. For the uninitiated, the RSA Conference (RSAC) is the largest annual gathering of information security professionals in the world. In the court of public opinion, RSAC was gravely disappointing. Order, order! The court is now in session.

In my newsfeed, the charges levied against RSAC19 are:

  • Neglect in the 1st degree
    • I didn’t get anything from the sessions I attended. “I picked the perfect schedule and am offended that they weren’t exactly tailored to me!”
  • Assault in the 2nd degree
    • The expo floor was SO overwhelming. “I cannot believe that companies would send their marketing and sales professionals to accost me!”
  • Misrepresentation
    • Some percentage of the vendors showcasing their product don’t understand my needs and won’t be here next year. “EVERYONE should be polished and know my exact use cases!”

Ok, the bullets above might be a little facetious, but they sum up what I have read over the last few days. I poke a little fun, and those who pressed charges aren’t completely incorrect, but it also isn’t as black and white as many make it out to be.

Some bright rays of optimism and positivity did punch through the clouds of despair! Tales of accidental run-ins with the industry elite (For me it was Gary Hayslip #CISOapproved), learning about new behavior-based detection tools, password alternatives, and, more than anything, connecting with trusted partners and long-lost accomplices in the world of information security.

Interestingly, some of the negative write-ups included positive anecdotes but didn’t connect the dots between the good and the bad. Can you have the good without the bad? Can you run into your idolized legend at The W Hotel Bar if he wasn’t in town presenting a session that you’d later pan for your online audience?

Ultimately RSA is what you make it. This is true for any large, international conference regardless of the subject matter and I learned the hard way at the annual HIMSS gathering several years ago in Chicago (now moved to Orlando and Las Vegas). It was daunting. Over 70,000 HealthIT nerds, analysts, providers, vendors, and sycophants descended on an unsuspecting city just like the cyber warriors parachuted into San Francisco this week. It was overwhelming, vast, exciting, scary, and awe-inspiring. The sheer concentration of talent boggled my mind. Initially I didn’t know what to think; I was scared and didn’t have a plan, so I blamed the event for being “too much”, “disorganized”, and generally exclaimed “WTF” at least once an hour. After I got home and binged House of Cards for two days to recover, I resolved to come up with a plan instead of dwelling on my gloomy perceptions.

Boom. The value suddenly came into focus. The event didn’t change – in fact it got bigger and more complex. Rather, I changed my expectations, schedule, and execution. I have done the same with RSA over the last several years. This year I asked myself some simple and important questions a few weeks before stepping foot into Moscone. At the most basic level it boils down to attending with purpose.

  • What are my organization’s InfoSec priorities? Pick 3 or 4 and don’t deviate. Things like data loss prevention (DLP), identity management, and incident response.
  • Who do I NEED to talk to? Partner relationships, new product demos, etc.
    • Bonus points for who do I WANT to talk to
  • What do I want/need out of this week in general? Am I focused on parties and swag (nothing wrong with that!), learning about new products, or advancing my own knowledge in areas that I’m lacking?
  • How will I spend my free time (if there is any)? Early stage expo? Full expo? Hanging out at Starbucks? Catching up on email? Meeting friends?
  • What do I need to bring back to my organization? Spoiler alert: this is easy to answer if you fully consider the previous questions
    • These events aren’t cheap – how am I maximizing my organizations investment into these few days?

I am disappointed in all of the hate towards RSAC this year. As a community we need to collaborate now more than ever. If you wrote something negative about the conference this year, I don’t mean to put you on blast. I do ask, though, that you channel your energy towards making next year better. Many talented, smart, innovative, and dedicated security professionals are at the helm of this event. Give them real and actionable feedback, apply to speak on a topic that you’re passionate about, or at least commit to planning your experience with purpose.

Happy Holidays HIMSS NorCal Members!

What a year it has been so far! This has been a very busy past few months for most of us, especially for the HIMSS NorCal Chapter. We have only just recently wrapped up our Annual CxO Summit, our first educational program of the year, co-chaired by Nick Steinbach and Sherri Douville. This incredible event brought together a spectrum of industry leaders and experts in policy tech and medicine to show us how to apply tools like analytics, security, mobile, and innovation to drive the transformation needed to improve patient outcomes and reduce costs to allow us to respond to urgent policy and payment shifts. Check out the highlights in the article below!

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Highlights from the HIMSS NorCal CxO Summit: Facing Disruption Head On

Healthcare IT enthusiasts came together on October 16 at the HIMSS NorCal CxO Summit in Santa Clara to be inspired and learn from experts in the field about best practices associated with this year’s theme “Facing Disruption Head On.” If you were not able to join us then, here are some highlights that you may have missed.

We were extremely honored to hear from John Chambers, Chairman Emeritus at Cisco, Founder and also now a VC at JC Ventures. He was interviewed by Sherri Douville, CEO of Medigram and CXO Co-Chair. John shared insights gained during his successful 20 year career as Cisco’s CEO, then Chairman of the Board. John led Cisco to become an innovative IT powerhouse, growing revenue from $70M in 2005 to $47B in 2015. As an experienced leader, he has an eye for spotting and shaping startups that have the potential to become the next Cisco.

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Don’t Miss Our Upcoming 2019 Meetups!

We have two exciting meetups in the new year that you should not miss!

We are very excited to announce our first meetup ever serving our North Bay community on January 10 at La Rosa Restaurant in downtown Santa Rosa. Break out of the day-to-day grind and enjoy an evening out with other professionals committed to advancing healthcare information technology. This casual social event is an opportunity to forge new relationships and build a thriving network. Step away from your desk and get (re)connected! As the first HIMSS NorCal Chapter meet-up specifically for North Bay professionals, your participation will be foundational to building a local HIT community – without the commute to SF. Let’s do this! RSVP here:

For our Sacramento based community, join us at our next meetup on January 24 at Shriners Hospitals for Children, where the focus will be: Cybersecurity / Device Management in the Healthcare Setting. We hope to inform and inspire attendees on this topic in order to further the improvement of safe and secure solutions for better patient outcomes. Gain insights on what our thought leaders are implementing, thinking about, and ruminating over. This panel discussion will be moderated by Michael McCune, Cybersecurity Development, and features:

  • Monte Ratzlaff, Cyber-Risk Program, UC Office of the President
  • Jason Elrod, Chief Security Architect, Sutter Health
  • David Finn, EVP, Innovation for CynergisTEK (formerly of Symantec)
  • Marcus Grindstaff, COO, Care Innovations

RSVP for our Sacramento Meetup here:

As always, entry to our community based meetups is free. Just make sure you RSVP on the Meetup. Hope to see you in the New Year!

7th Annual Innovation Conference & Showcase: The Blueprint for Putting Patients at the Center of APIs

Save the date for our 7th Annual Innovation Conference and Showcase on March 19, 2019 at ITU in San Jose, CA!

Making health data useful to patients is a national priority—and the APIs needed to realize this goal by facilitating data sharing and consumer access are rapidly finding regulatory and market commitment. Is your organization ready to meet the demand? Join us to discuss how to build and advance the tools and capabilities you will need for laying a technical foundation of engaging interfaces to make data available to patients and drive high-value interactions with them. What’s more -- we’ll share a state of the industry update on consumer-directed exchange and showcase promising efforts around the bend from leaders in the industry to help point the way forward.

Learning objectives:

  • Learn how you can support and encourage broad adoption of openly accessible APIs to rapidly advance the ability for consumers and their authorized caregivers to easily get, use, and share digital health information when, where, and how they want it.
  • Understand the business case for implementing consumer APIs and leveraging them to expand the reach of your organization.
  • Prepare your organization for policy implications around consumer controlled APIs—get up to speed on what's required and get started with a plan to meet those requirements.
  • Learn how to leverage standards and safeguards to support patient access, while preserving privacy, security, and patient preferences.
  • Explore ways to promote better electronic access to a consumer’s clinical and payment information via third party applications by engaging with startups and developers.
  • Create new ways for providers to engage and connect with patients and enrich clinical workflows by bringing pertinent health data into focus to facilitate increased patient empowerment and shared decision making between providers and patients.

Registration will open soon!

Beyond Brick and Mortar: Busting Down the Barriers to Healthcare

The date for the 2019 ePatient Summit has been set! Join us on April 25, 2019 at Salesforce East in downtown San Francisco!

Preliminary Topics include:

  • Innovative technology-driven transportation partnerships
  • Voice-enabled patient/provider interactions
  • Innovative ways to receive care (ie: virtual triage, chatbot, call doctor to your door via app)
  • Social determinants of health and how technology is making it possible
  • Evolution of healthcare

Registration will open soon!

Spotlight: Jason Johnson, President-Elect

Congratulations to Jason Johnson, our Chapter’s President-Elect, for earning the designation of Fellow Member of HIMSS! The FHIMSS designation is awarded to professionals who are actively taking a leadership role in advancing healthcare IT. It distinguishes one’s commitment to having a positive impact on the healthcare industry overall. Jason has been active in the Northern California Chapter since 2015. He currently serves on the Finance Committee and as a Programs Adviser in addition to his responsibilities as the President-Elect. As Information Security Officer at Marin General Hospital, Jason is responsible for information security, hospital communications infrastructure and user experience projects. In addition to FHIMSS designation, Jason holds a CISSP certification, several Microsoft certifications and a BLS certification. We are proud and thankful to have such a committed professional leading Chapter initiatives!

End of the Year Recap

By Nick Steinbach, President, HIMSS NorCal Chapter

As your President, I would like to take this opportunity thank our membership base for their support. What a year we have had! With the summer season upon us and the finish of our 2017/2018 program year -- this is a great time for reflection and planning.

We wrapped up the year with an incredibly engaging annual ePatient Summit at UCSF Mission Bay, visiting our legislators at the Capitol for HIT Advocacy Day, and celebrating this year at our end of the year social at Rosenblum Winery in Jack London Square. I encourage you to read about their highlights in the articles below!

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Recapping the (dis)Connected Patient

By Jenni Bendfeldt, Secretary, HIMSS NorCal

On May 3, the HIMSS NorCal Chapter hosted its annual ePatient Summit conference at the UCSF Mission Bay campus in San Francisco. Approximately 165 healthcare professionals gathered to share ideas and discuss the operational, technical, and regulatory challenges that plague healthcare and create the (dis)connected patient.

At the event, attendees learned how Shannon Wright, Executive Director of the ESRD Network of the South Atlantic, overcame interoperability and resource challenges to maintain patient care during Hurricanes Maria and Irma, how Dr. Sara Murray and Dr. Russ Cucina, VP, Chief Health Information Officer at UCSF Health System, improved the accuracy and efficiency of ordering medications through the UCSF EHR, and the latest regulatory and technical developments around FHIR from Chris Fierer, Director of Innovation at MedFusion.

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HIMSS State HIT Day 2018

By Shanti Wilson, HIMSS Vice Chair, Western Region Advocacy, HIMSS NorCal Advocacy Chair

The HIMSS Advocacy team representing Northern and Southern California had a great State HIT day on May 16, 2018. The day was filled with education, advocacy, and meaningful conversations. Shanti Wilson, HIMSS Vice Chair, Western Region Advocacy and HIMSS NorCal Advocacy Chair, kicked off the day with a discussion about advocacy and what it means to HIMSS. In short, advocacy is being passionate about a cause and wanting to make a difference. HIMSS focuses its passion on improving health through IT.

Jeff Coughlin, HIMSS Senior Director of Federal & State Affairs, provided insight on what is happening in Washington D.C. and at the federal level with regard to HIT. He discussed interoperability, information blocking, the work to reduce opioid dependence, telehealth, and precision medicine. If you are interested in joining a new venture to support precision medicine research, you can sign up here:

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Sacramento Meetup: Information Security in Healthcare

By Evelyn Milani, Education Committee, Sacramento MeetUp Chair

The Sacramento Information Security MeetUp had over 60 people in attendance, and consisted of executives, service providers to the industry, innovators, and clinicians. We met at a beautiful venue at Shriners Hospital for Children, and Experis provided a lovely catered experience.

The high performance panel was moderated by Kevin Spease, Managing Partner at ISSE Services, and featured the following panelists:

  • Monte Ratzlaff, Cyber Risk Program Manager, UC Office of the President
  • Jason Elrod, Chief Information Security Architect, Executive Director, Privacy and Information Security, Sutter Health
  • John Hainaut, Vice President, Information Security, Experis

Attendees were treated to a lively panel who discusses the impact of security for improved patient outcomes and what the biggest current threats are. The takeaways include:

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Reflecting on the Clinical Advisory Council

By Margit Chapman, Education Committee, CAC Chair

I had the pleasure and honor this year to chair the newly formed HIMSS NorCal Clinical Advisory Council (CAC), comprised of physicians, pharmacists, RNs, and informaticists. This was a pilot project sponsored by the HIMSS NorCal Education Committee. Our goal was to ensure that topics of interest for clinicians were included at various HIMSS NorCal Chapter events to better serve our membership and boost event participation from physicians, pharmacists, and RNs.

The CAC had a very active year, contributing ideas, critiques, and helpful advisory in the planning for the ePatient Summit, which resulted in a rich agenda of speakers and panelists. In addition, the CAC compiled topics that would be of interest to clinicians to pursue through our Regional Program Directors for HIMSS NorCal MeetUps.

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Message from the Board

Hello Everyone and Happy New Year!

We hope that 2018 has gotten off to a great start. The Board is back at it, and hard at work for the second half of our fiscal year.

We started 2018 on a positive note with our sixth annual Innovation Conference and Showcase at the Intel Auditorium in Santa Clara on February 1 that brought in over 200 attendees. Check out the recap in the newsletter below.

Looking forward, we have an incredible lineup of events still to come, which includes our ePatient Summit on May 3 and State HIT Day on May 16. Our committees are tirelessly working to bring to you the best possible programs, and part of being able to do that lies within our Sponsorship. We’d like to thank our Annual Sponsors for their committed contributions to our chapter, because without them, we would not be able to continue to take our events to the next level.

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AI and Precision Medicine Top This Year’s Innovation Conference and Showcase

By Lauren Mock, Innovation Committee Chair

With over 200 in attendance, our sixth Innovation Conference and Showcase at the Intel Auditorium in Santa Clara was a tremendous success. A stellar array of thought leaders explored how topics such as Artificial Intelligence and Precision Medicine are maturing and their impact on patient care, and how the advancements made by technology leaders in non-healthcare industries can positively impact the healthcare ecosystem.

This year’s conference addressed four main topics:

  • Precision Medicine - the challenges and opportunities of shifting from a one size fit all approach to personalized treatments.
  • Artificial Intelligence - will the hype live up to the expectations?
  • Public and Private Partnerships - examples of public and private entities joining forces in the name of innovation.
  • Beyond Healthcare - what lessons on innovation can healthcare gain from other industries?

Our keynotes and panels presented perspectives from inside and outside healthcare on how innovative thinking can be applied to clinical and consumer workflows, and to healthcare delivery systems.

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Networking Reception at HIMSS National with the Northern California Chapter

What a conference! We had such a great time with all of you who came to our annual Networking Reception at HIMSS National in Las Vegas.

Like with previous years, this event quickly sold out. We had over 100 attendees and enjoyed seeing familiar faces from Northern California, but we quickly made new friendships with attendees from across the US and the UK over appetizers and drinks.

Huge thank you to NTT DATA for helping with the festivities! We hope to see you again next year!

HIMSS NorCal is on LinkedIn and Twitter!

By Maital S. Rasmussen, Marketing Committee Chair

Please follow HIMSS NorCal on LinkedIn to stay informed of the latest updates from the chapter. You can access our profile here:

Don’t forget to join our HIMSS NorCal LinkedIn group, which is a discussion forum for our Chapter community members on healthcare topics such as Digital Health and Health IT. You can join the conversation here:

We’re also on Twitter! Follow us here:

Health IT Advocacy Updates

By Shanti Wilson, Vice Chair, Western Region Advocacy, HIMSS NorCal Advocacy Chair

As the State legislature started session in early January, our joint HIMSS Northern and Southern California Advocacy team started monitoring Health IT legislation. Below are some of the bills the team is currently assessing for potential areas to focus on during our upcoming State HIT Day on May 16.

SB199 - Senator Ed Hernandez: Health Cost and Quality

  • Establishes advisory committee that includes reviewing IT to improve quality and reduce cost

AB1136 - Susan Eggman: Health Facilities/Residential/Mental Substance Use Disorder Treatment

  • CDPH to solicit a 21st century CURES act to collect and display information about mental health patients and treatment facilities, require a database to be created to collect and track data

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New! HIMSS NorCal Now Offers CMEs at Select Events Starting May 2018

By Cindy Zheng-Huang, Education Committee

Medical discoveries and methods of healthcare delivery are advancing rapidly, and medical practices are being impacted by these breakthroughs. Physicians, nurses, and clinical and health IT professionals are on an exciting and overwhelming stage with all the information available today. With the current state of healthcare, being informed of best practices with respect to new healthcare technology is critical to the continuing education of medical professionals so that these new approaches can be adopted to improve health outcomes.

Physicians must earn Continuing Medical Education (CME) credits to meet the requirements of state medical boards, medical specialty societies, specialty boards, hospital medical staff, the Joint Commission, insurance groups, etc. Likewise, earning Continuing Education Units (CEUs) is required for professionals like nurses with certificates or licenses. The quantity of required CME or CEU credits varies by state and specialty. To meet the requirements to earn CMEs or CEUs, all educational activities that a professional participates in need to be given by accredited providers.

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Agenda Highlights for the 2018 ePatient Summit

By Dr. Robert Wilkov, ePatient Summit Committee

We are proud to announce the 6th Annual ePatient Summit on May 3, 2018 in Robertson Hall at the UCSF Mission Bay Conference Center.

The ePatient Summit promises to be the largest and most exciting clinical event of the year. It focuses on the key challenges and solutions to engage patients across the continuum of care, a key element of the IHI Triple Aim framework. 

Who should attend? Physicians, Nurses, CxOs, Clinical Informatics, IT Professionals, Health Innovation Leadership, Care Coordination Managers, Entrepreneurs and anyone passionate about improving the delivery of care are welcome.

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HIMSS 2018 Chapter Challenge Winners

Please join us in celebrating our recognition by HIMSS National for having the highest count of registered members in the Western Region!

Eastern Chapter — Highest Count of Registered Members — New England

Western Chapter — Highest Count of Registered Members — Northern California

Eastern Chapter — Highest Percentage of Registered Members — Puerto Rico

Western Chapter — Highest Percentage of Registered Members — Nevada

We thank you for your continued efforts to optimize health engagements and care outcomes through information and technology with the HIMSS Northern California Chapter.

Join us for California State HIT Day!

The Northern California and Southern California Chapters of HIMSS are pleased to invite you to their annual State HIT Day on May 16, 2018 in Sacramento at the RCRC (Rural County Representative of California) Building; 1215 K Street. This is your annual opportunity to hear about Health IT policies affecting you and go to the Capitol to speak with your representatives to impact current state legislation. After the educational sessions provide a common foundation, we will visit legislative offices to pass on this education and inform our representatives. We look forward to seeing you there. The day will feature:

  • National policy updates
  • State legislative updates
  • HIT industry updates on topics such as: Telehealth, Privacy and Security and Health Reform
  • State Capitol legislative visits

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Get Involved with the Chapter!

Want to help plan one of our annual programs or join a committee? Volunteering for our fabulous events or getting involved with program planning, communications and sponsorship are great ways to expand your professional network and advance your career. It's fun, too!


Message from the Board

Happy holidays HIMSS NorCal members!

What an incredible fall quarter! This was such an eventful time of the year for our chapter, from the CxO Summit to Meetups, to Advocacy wins and Education outreach.

The CxO Summit was our first education program of the year, at which our event committee co-chaired by Nick Steinbach and Jason Johnson brought an incredible speaker lineup who discussed how unprecedented advances in digital technology are transforming how healthcare is delivered. This was our third event for the fiscal year, and we are happy to report that it was a sold out success just like the first two!

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CxO Wrap Up

By Jason Johnson, Programs Committee Chair

The rainy weather didn’t dampen our great time at Citrix HQ for our 5th Annual CxO Summit in November! Those who attended heard about the industry outlook from Gartner’s perspective during Vi Shaffer’s engaging keynote.

We also hosted Todd Dunn, Director of Innovation for Intermountain Health, for his take on how innovation isn’t the only path to transformation. He discussed design-thinking and offered some simple tools that can be used to quickly put together a business model or vet the value proposition of a new idea. From there, policy experts debated on which comes first: innovation, transformation, or policy, and the jury is still out!

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HIMSS NorCal is now on LinkedIn!

By Maital S. Rasmussen, Marketing Committee Chair

Please follow HIMSS NorCal on LinkedIn to stay informed of the latest updates from the chapter. You can access our profile here:

Don’t forget to join our HIMSS NorCal group, which is a discussion forum for our Chapter community members on healthcare topics such as Digital Health and Health IT. You can join the conversation here:

ICYMI: HIMSS Sacramento Meetup

“The Mindset of a Hacker: Tackling Digital Security Together”

By Serena Kouklis, HIMSS NorCal Meetups Team

What: “The Mindset of a Hacker: Tackling Digital Security Together”
When: 11/9/2017, 6-8pm
Where: Sutter Health’s Patrick Hayes Learning Center

Julian Garcia, Sr. Security Engineer at SecureWorks gave a presentation on cybercrime on November 9 to a crowd of healthcare and IT professionals. Below is a short summary of what he had to say:

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CPHIMS Comes to HIMSS NorCal

By Jessica RayMarco Lopez, and Deborah Kohn, Education Committee

The HIMSS Northern California chapter is pleased to announce new developments to assist its members in obtaining the CPHIMS (Certified Professional in Health Information & Management Systems) distinction. As with any professional certification, the process may seem daunting and out of reach. But fear not! Our chapter will be offering two, in-person, day-long, CPHIMS examination review classes per year, one in the spring and one in the fall. We are also pleased to announce that members who have provided at least one year of volunteer service to our chapter will be eligible for reimbursement of the cost of the certification exam.

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State Official of the Year

Western Regional HIMSS Advocacy Vice Chair and Northern California Advocacy Chair, Shanti Wilson, along with Southern California Advocacy Chair, John Conklin, presented California Senator Ed Hernandez the “HIMSS State Legislator of the Year Award” on behalf of the National HIMSS Board of Directors. Senator Hernandez received this honor for his efforts that demonstrate a significant contribution to the positive transformation of healthcare through the use of information technology (IT). We thank Senator Hernandez for his leadership and dedication to Health IT demonstrated by his support of HIMSS California State HIT Events and for championing Health IT legislation.

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Want change? Get involved with HIMSS Advocacy

By Shanti Wilson, Vice Chair, Western Region Advocacy, HIMSS NorCal Advocacy Chair

HIMSS North America represents 70,000 individual members, 630 corporate members, and over 450 non-profit organizations and has over 5,000 right here in California. HIMSS supports connecting its members with state, regional, and national decision-makers on key health IT issues. With our political landscape being more divisive than most can remember, advocacy is a bi-partisan effort focused on improving the lives of all through health IT. There are many ways you can impact your community through advocacy. Below are 10-ways to get involved:

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Sponsorship Update

By Stevie Ryan, Past President and Sponsorship Committee

On behalf of the Sponsorship committee for the Northern California Chapter of HIMSS, we would like to take a moment to thank all the contributing sponsors that give our chapter the ability to put on meaningful and impactful programs, year after year. We have just recently wrapped up our annual CxO Forum on November 16, 2017 with amazing feedback! The following sponsors made this event possible: 

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Registration Now Open! 2018 Innovation Conference & Showcase - February 1, 2018

Be with us at the forefront of healthcare innovation and learn how topics such as Artificial Intelligence and Precision Medicine are maturing and their impact on patient care. Explore the advancements made by technology leaders in non-healthcare industries and how they can positively impact the healthcare ecosystem. Your HIMSS NorCal team is looking forward to having you bring your thirst for knowledge and desire to network with both like-minded and divergent-minded colleagues. Mark your calendars today and register below to receive reduced early bird pricing through January 5, 2018!

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Welcome from the Board

Dear HIMSS Northern California Members,

We had a great FY17 and are looking forward to seeing all of you at our FY18 events! Our board and committees are working to bring you several great events in the coming months. We started the year with our annual Fall Social / Giants Game. It was a huge success and a great networking opportunity. We have the following events planned for the rest of the year.

  • November 16, 2017 - Annual CxO Event
  • February 1, 2018 - Innovation Conference & Showcase
  • Spring 2018 - ePatient Summit
  • May 2018 - CA State HIT Day

Other exciting Chapter news includes the Advocacy Committee, chaired by Shanti Wilson. Shanti was able to present Senator Ed Hernandez with the “HIMSS State Legislator of the Year Award” on behalf of the National HIMSS Board of Directors. In addition, Shanti has also been named, Vice Chair, for the Western Regional Chapter Advocacy!

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A Recap on HIMSS NorCal Summer and Fall Socials

By Jason Johnson, Programs Committee Chair and Lauren Mock, Innovation Committee Chair

Summer Social

It was another great year at Rosenblum Cellars in Jack London Square for our 11th Annual Summer Social to celebrate our fiscal year-end. It was the perfect time to celebrate everything we have accomplished as a chapter in the past year and an opportunity to look forward to the next.

We have been celebrating at Rosenblum for the past two years, and it is a favorite waterside locale in the East Bay. We enjoyed the company of 75 attendees, including new chapter members and non-members, underneath the warm summer sun in an intimate setting.

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HIMSS NorCal is now on LinkedIn!

By Maital S. Rasmussen, Marketing Committee Chair

Please follow HIMSS NorCal on LinkedIn to stay informed of the latest updates from the chapter. You can access our profile here:

Don’t forget to join our HIMSS NorCal group, which is a discussion forum for our Chapter community members on healthcare topics such as Digital Health and Health IT. You can join the conversation here:

Sacramento Meetup Updates - MACRA and Machine Learning

By Evelyn Milani, HIMSS NorCal Sacramento Meetup Leader

The HIMSS NorCal Sacramento Meetup team has had two highly successful meetups these past few months with a lively, highly participative audience.

The Impact of MACRA on Physician Practices and Health Systems

Our panel of distinguished experts in the field of MACRA, payment policy, and overall healthcare policy provided feedback on lessons learned, policy changes, and how physicians have adapted to the policy.

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Announcing the HIMSS NorCal Clinical Advisory Council

By Margit Chapman, RN, CAC Chair

To bolster its ability to address market needs and enhance HIMSS NorCal’s value to physicians and clinicians, we have established the HIMSS NorCal Clinical Advisory Council (CAC). The CAC will be comprised of 10-12 representative Physicians, Registered Nurses, Pharmacists, and experienced leaders in designing clinical solutions who will contribute industry insights, fresh perspectives, and learned counsel to HIMSS NorCal’s leadership team. We will benefit from the inputs and recommendations offered by the CAC as it relates to our educational events, subject matter expertise, and organizational positioning.'

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Introducing Shanti Wilson, HIMSS Advocacy Vice Chair for the Western Region

With over 50 HIMSS Chapters across the United States, one of HIMSS' many strengths is to connect HIMSS members with local, state, and national decision-makers on key Health IT issues. The HIMSS Chapter Advocacy program provides an opportunity to support this regionally and locally, and we are proud to announce that our Northern California Advocacy Chair, Shanti Wilson, was recently appointed to the position of the Advocacy Vice Chair for the Western Region. She will support sharing best practices and the advocacy efforts of our Western chapters. Congratulations Shanti! If you are interested in learning more about advocacy or participating in advocacy activities, please contact her at

Advocacy Wins for AB 401 and 40

By Leslie Bruce, HIMSS Southern California Advocacy Committee

The 5,800 members of the HIMSS Northern and Southern California Chapters had cause for celebration when the Governor signed two bills important to the health of Californians recently, AB 401 and AB 40.

Signed on October 7, AB 401 enables registered pharmacy technicians in medically underserved areas to distribute drugs and devices under the supervision of a State Board of Pharmacy authorized pharmacist using a telepharmacy system. The 7.4 million Californians in medically underserved areas will benefit from increased access to their medication, enhanced medication adherence, and ultimately, improved health outcomes.

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Sponsorship Corner

Our 2017/2018 year is coming along greatly, and the Sponsorship Committee would like to share a new opportunity for our sponsors to promote their business and services to our membership.

Starting this year, we are offering the opportunity for our sponsors to leverage this HIMSS quarterly newsletter. There are several new promotions through which sponsors can purchase ad space at different levels. In addition, we will be promoting our sponsors each year on a full page ad. The following types of ads for purchase in our future newsletters are:

  • Front page ads
  • Full and half back page ads
  • Highlights in our sponsorship logo corner
  • Annual sponsorship article will highlight all our sponsors throughout the year

If you are interested in purchasing ad space in our newsletter, please contact our Sponsorship Committee Chair, Michelle Heimann at

Davies Award Winner

We are proud to announce that the first Davies Award winner is from our region! Dr. Danielle Oryn and the team at the Petaluma Health Center (an FQHC in Petaluma, CA) are on the cutting edge in visual management of data, especially in the community health center sector. PHC has used an innovative analytics interface to create a culture of providers pulling care delivery and outcomes data as part of their regular workflow to identify opportunities for improvement. Dr. Oryn and her team are a terrific resource for improving population health and chronic disease management through the use of information technology.

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Save the Date! Annual CXO Summit on November 16

Digital Transformation - Leading from the Edge

Unprecedented advances in digital technology are transforming how healthcare is delivered. The potential of these technologies to streamline care delivery workflows, enhance security and improved patient experiences, is an attractive proposition for healthcare enterprises, but one that demands an expansion of the traditional roles of HIT.

Come learn from leading CXOs, physicians and national experts as they share best strategies for identifying products and services, managing and storing data, partnering and acquiring talent, and building world class healthcare systems of the future. Hear how organizations are integrating the latest technologies into existing business models and IT architectures to improve services.

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Call to Action: Participate in Virtual March on Washington!

By Shanti Wilson, HIMSS NorCal Advocacy Committee Chair, HIMSS Advocacy Vice Chair for the Western Region

HIMSS National Advocacy is having a virtual march on Washington to advocate for Health IT legislation.

Please make your voice heard through our Virtual March on Washington! Contact your elected officials in Congress quickly and easily with our letter highlighting HIMSS 2017 Congressional Asks.

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Message from the President

Hello Northern California HIMSS Membership!

Thank you for tuning in to another edition of our quarterly newsletter! As I mentioned in our last edition, our board had been hard at work on several events, which I am happy to report, went off without a hitch. Our 5th annual ePatient Summit brought close to 300 attendees to the Technology Museum of San Jose where we had the pleasure of partnering with El Camino Hospital to bring a unique experience to attendees through a dynamic speaker lineup combined with hands on workshops addressing the positioning of patients both as “consumers” and as “partners.” The goal of our committee chairs, Santosh Mohan and Samir Batra, was to discuss disruptive ideas and the impact of IT, while providing actionable takeaways on building both a 21st century consumer strategy and an exceptional patient experience. They were able to accomplish all of that and then some, as the feedback has been phenomenal.

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An Open Invitation From Your Incoming Board

By Jim Bloedau, incoming 2017-2018 NorCal HIMSS Chapter President

It is an immense pleasure and honor to be your President of the Northern California Chapter of HIMSS for the coming 2017-2018 fiscal year and to lead the execution of our Chapter’s primary mission - to promote the professional growth of the membership. Our approach to this challenge stands on three legs: offering outstanding educational content, hosting networking events, and collaboratively advocating HIT related legislation at the state and national level.

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Welcoming the 2017-2018 Executive Committee Chapter Officers

By Stevie Ryan, Past President 2017-2018 and Jim Bloedau, President 2017-2018

Tasked with providing the executive leadership of the Chapter’s Board of Directors, our Executive Committee (EC) is comprised of five officers – President, President-Elect, Past-President, Treasurer, and Secretary.

As your next Past-President and incoming President, Stevie and I warmly welcome our new Executive Committee officers. These are highly talented and extremely exceptional people who are no stranger to the Board with up to five years of board experience preceding their election as an officer.

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HIMSS Members Advocate for Telehealth and Interoperability Legislation

By Shanti Wilson, NorCal HIMSS Advocacy Chair, Dr. Larry Ozeran, NorCal HIMSS Advocacy Co-Chair, John Conklin, SoCal HIMSS Advocacy Chair, Ian Slade, Western HIMSS Advocacy Chair

With leaders from the National HIMSS office, over 70 members from the Northern and Southern California HIMSS Chapters participated in the annual California HIMSS State HIT Day on May 3, 2017. Our members and colleagues gathered in the State Capitol to advocate for issues that impact California residents.

For the first half of the day, attendees heard from local and national leaders about the importance of having dialog with our elected officials and the key issues on the national stage.

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WHIT Inaugural “Path to Success” with NorCal HIMSS

By Sherri Douville, CEO for Medigram, Inc, @SherriDouville
The WHIT/Women in Health IT Committee, @WomenInHealthIT

WHIT (Women in Healthcare IT) was founded in 2015 with an objective to seed, incubate, and advance women’s career aspirations in Healthcare IT. Affiliated with both NorCal and SoCal HIMSS Chapters, WHIT is led by women in executive and senior leadership IT roles who are passionate about bringing more female talent to Healthcare IT.

With HIMSS, WHIT held its inaugural event, “Path to Success,” on May 19 at the Presidio in San Francisco. “Path to Success” aspired to provide career advice and mentoring to women and girls interested in furthering their careers in IT and STEM. Chaired by Sunny Cooper, CIO of San Francisco Health Plan, and Melissa Scrymgeour, CIO of Gold Coast Health Plan, the event was headlined by Healthcare IT’s top women including political advisors, journalists, C‐level executives, and technologists. Jason Johnson, Board Member for NorCal HIMSS, provided substantial additional leadership and support planning. A huge thanks goes to Sunny's staff for all their hard work on the event, in particular to Corinne Young and Van Wong.

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CPHIMS Review Course

By Cathy Coleman, DNP, CNL, CPHQ, Education Committee, CPHIMS Course Coordinator

On June 9, the NorCal HIMSS chapter held a CPHIMS Review Course hosted at the University of San Francisco Pleasanton campus. Twenty eight interprofessional attendees representing over 23 healthcare clinical settings, information technology companies, public health departments and integrated delivery systems learned the latest content from a seasoned  The course was lead by HIMSS trainer Deborah Kohn, MPH, RHIA, FACHE, CPHIMS, FHIMSS, CIP, Principal, Dak Systems Consulting.

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Upcoming Events with our Sacramento Meetup Group

By Evelyn Milani, NorCal HIMSS Sacramento Meetup Leader

The NorCal HIMSS Sacramento Meetup Group continues to thrive by providing timely updates and information on key topics for our Health IT community.  

Our Meetup on June 23 is focused on MACRA, its impact on health systems and private practices, and how IT plays a part in tracking quality measurements. Our panelists, a veritable “who’s who” in the field, will respond to questions on how to navigate Change Management, lessons learned from prior implementations, and how to maximize success upon implementation. Join us here!

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Forget Fancy Tools: Back to the Basics of InfoSec Impact of WannaCry on Hospitals & Healthcare

By Jason Johnson, Board Member, NorCal HIMSS

Raise your hand if the last couple of weeks have made you WannaCry. For the record, my hand is up. Since the outbreak of the WannaCry ransomware worm on May 12, security professionals and system administrators have been scrambling to patch systems, gather data, and assess the real impact.

While the latest cyber incident did not have a huge impact in the US, save for some Bayer medical gear running XP, it did wake people up all over the world to the reach that a cyber attack can have. But wait, everyone said there was a patch released two months ago, so currently patched and updated systems are not vulnerable. What a relief, right? Wrong. Since most large organizations, especially in healthcare, are 90-120 days behind on patching, countering this outbreak was squarely on the shoulders of system administrators. Healthcare is especially vulnerable since some systems are vendor managed and/or FDA-regulated.

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Questions for Hospital Executives to Ask to Avoid Bad Mobile Technology Advice

By Sherri Douville, CEO for Medigram, Inc, @SherriDouville

I was inspired to write this for all of the amusing and bad technology advice for which health system customers are perplexed. To one vendor, one health system executive said, "I need you to send your suits and khakis home and return with technical people to tell my team exactly why this is not working in our environment." The purpose of this article is to assist healthcare executives to filter which solutions to consider beyond following the crowd.

Why Bad Technical Advice Gets Out: If you have worked with engineers closely, you know that programming languages and other tools and skills are almost like religions. Therefore, whatever they are good at is what they want to promote, really this is human nature. At least in a startup, a big part of the CEO's job is to impose a technology BS filter. One thing we cannot accept is the choice of a tool without a complete explanation for the purpose and rationale as applied to the targeted outcome. This is pertinent in healthcare, where we should be wanting to help clinicians and serve patients or go into a different vertical. To do this effectively, we need to examine the technology being advised and to filter that advice.

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HIMSS Announcements

By Jim Bloedau

Education Assistance Fund – Apply this Fiscal Year

HIMSS can provide financial assistance to chapters for speaker and/or educational programming costs related to a specific chapter event. There is a maximum request of $1,000 per chapter and funds are given based on availability and need. Chapters can receive one assistance payment per fiscal year.

To request assistance, download and submit the following form to Chapter Staff.

HIMSS Health IT Value Suite

The HIMSS Health IT Value Suite & Value Score provides the resources to help enterprises organize value strategies and analyze its impact. Begin to build and measure the organization’s value strategy today. 

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Message from the President

Hello everyone and happy new year! I hope that 2017 has gotten off to a great start for all of our Northern California HIMSS Chapter Members. I can say that our Board is back at it, and hard at work for the second half of our fiscal year. We started 2017 on a positive note with our fifth annual Innovation Conference and Showcase at the Intel Auditorium on January 12 that brought over 200 attendees. Our talented event committee brought together the leading innovation physicians and national clinical HIT innovation experts from around the country who offered their forward leaning perspectives. The feedback has been incredibly positive, and was a fantastic follow-up to our CxO event last November.  

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ePatient Summit - April 4, 2017

By Dr. Bob Wilkov

NorCal HIMSS, in collaboration with El Camino Hospital and The Tech Museum of Innovation, is excited to host its annual flagship event on Patient Engagement on April 4, 2017 in San Jose, CA. Now in its fifth year, the 2017 ePatient Summit will focus on the latest digital innovations, big impact trends, and most prominent challenges shaping patient experience and care in Northern California and beyond.

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HIMSS 2017 Conference - Chapter Highlights

By Jim Bloedau, BS-MT, RRT, CPHIMS, President Elect, Innovation Chair, Northern California HIMSS

Our chapter was well represented at the 2017 HIMSS Conference in Orlando on February 19-23. From speaking engagements and Fellowship and Leadership awards to one of the best attended receptions, our board continues to get more deeply involved and become increasingly respected at the national level. As usual, board members unanimously reported that if you weren’t walking at least 15,000 steps per day, you weren’t taking full advantage of what the conference offers. Here are a few highlights from those who attended.

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CPHIMS Review Courses

By Cathy Coleman, Course Coordinator, Education Committee

Experienced professionals in HIT, clinical care and management are eligible for the national CPHIMS certification exam, which has been very popular for HIMSS members and non-members who want to advance their careers and validate their knowledge, skills and abilities through this special recognition (

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National HIMSS Advocacy Challenge Winner

By Shanti Wilson, HIMSS Northern California Chair of HIT Advocacy and Ian Slade, HIMSS CAR Vice Chair Western Region 

HIMSS put out its first student advocacy challenge to find ways to support advocacy in your state. California won that challenge and below is Reginald Tuyay’s (the winner) proposed policy recommendations to reduce childhood obesity using Health IT. He is working with the Northern and Southern California HIMSS Chapters to advocate this and will be attending the May 3, 2017 State HIT Day in support of this. Below is the Abstract for his policy recommendation.

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Analytics and AI Dominate the 5th Annual Innovation Conference

By Jim Bloedau, BS-MT, RRT, CPHIMS, President Elect, Innovation Chair, Northern California HIMSS

With over 235 in attendance, the Chapter’s 5th Innovation conference was a fabulous success with many in attendance stating that it was the best ever. A stellar array of thought leaders explored how models that reward clinicians for improving patient outcomes rather than volume of care are being matched by health information technology (HIT) as it transitions to a post EHR era.

Our keynotes and panels presented perspectives from inside and outside healthcare on how innovation thinking can be applied to clinical and consumer workflows. They stressed that merely automating a task is taking a backseat to real-time analysis of key performance indicators needed on our road to personalized healthcare delivery. Sessions included:

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Sacramento January MeetUp

Good Energy Coming from the State’s Capitol City! Recap on the “Innovations in Healthcare, Progress and Challenges” MeetUp

By Evelyn Milani, Chair, Sacramento Meet-Ups

The Sacramento region has a robust healthcare ecosystem with people who share a passion for technology that is developed to improve patient outcomes, support better payment systems and policies, and improve efficiencies for clinicians and care teams.

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Advocacy 101 - USC Lecture Excerpts

By Ian Slade, HIMSS CAR Vice Chair Western Region

Recently I had an opportunity to speak to freshmen students at the USC School of Pharmacy. The lecture was part of a three-piece Advocacy session aimed at providing an overview of why Advocacy matters and how the students can get involved.

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Message from the President

Happy Holidays NorCal HIMSS Members!

This is always a very busy time of the year for most people, and for our NorCal HIMSS Chapter, that is no exception. We are just coming off of our Annual CxO Summit, our first educational program of the year, at which our event committee co-chaired by Nick Steinbach and Santosh Mohan brought about an incredible speaker lineup designed to facilitate productive dialogue and accelerate collaboration between CIOs, CMIOs, IT leaders and their non-IT executive colleagues. This was our third event for the fiscal year, and we are happy to report that it was a sold out success just like the first two!  

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How Do You Innovate What You Can’t See? Searching for the Unknown

By Jim Bloedau, BS-MT, RRT, CPHIMS, President Elect, Innovation Chair, Northern California HIMSS

Innovation is a well-worn term these days. If you Google “what is innovation,” 107 million listings appear, which contain thousands of definitions. We use words like change, revolution, transformation, breakthrough and modernization to describe what we used to call “new,” or today, what we call “innovative.”

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Are You A Savvy Marketer? Great Opportunity To Position Yourself in the Northern California Healthcare Community

Our chapter is actively seeking savvy-experienced marketers to help form our Chapter Marketing Group that will elevate and leverage the Northern California Chapter of HIMSS brand within our region. Our challenge is to find a number of amazingly talented, passionate and gracious people who can help form and lead marketing teams that:

  • Develop our overall messaging that promotes the mission of our chapter and events by reaching out to our unique audience in a separate and distinctive manner from traditional news media
  • Regularly produce new content on healthcare and health IT issues through original works of the membership, curation of previous “must read” resources or cultivating topical online discussions...

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Introduction to MACRA

By Larry Ozeran, President, Clinical Informatics, Inc.

Now that the elections are behind us, most of us in healthcare are focused on MACRA (Medicare Access and CHIP Reauthorization Act of 2015). MACRA was how Congress replaced the SGR (Sustainable Growth Rate) after years of unsuccessful legislative alternatives. In the last 20 years, only the 2010 ACA (Affordable Care Act) is likely to have a bigger impact on our healthcare system than MACRA. (If the ACA is repealed . . well, that is a story for another day.)

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National HIT Week - Advocacy Committee

By Ian Slade, HIMSS CAR Vice Chair Western Region
and Shanti Wilson, HIMSS Northern California Chair of HIT Advocacy

The week of September 26, 2016 was National Health IT Week. This year’s theme celebrated precision medicine, telemedicine, women in IT and interoperability. The Northern and Southern California HIMSS Chapters presented the “Commitment to Health IT” award to the University of California, Davis Health System for their ongoing excellence in using IT to improve the health of Californians. We had the pleasure to hear from prior Davies and EMRAM Stage 7 winners Dr. Jeffrey Wadja, CMIO, John Cook, Interim CIO and Dr. Scott McDonald, EHR Medical Director. Over fifty attendees participated, and we were able to have a personal tour of their state of the art hospital. Congratulations to our UC Davis partner!

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2017 ePatient Summit

By Margit Chapman

The Northern California HIMSS Chapter continues its annual patient-centered HIT learning and networking event. The ePatient Summit planning committee is excited to be orchestrating an amazing conference for 2017, in collaboration with El Camino Hospital and The Tech Museum of Innovation in San Jose, to focus on the latest digital innovations, big impact trends and most prominent challenges shaping patient experience and care in Northern California and beyond. We will have a full spectrum of industry leaders, experts and patients weighing in on consumer driven approaches in healthcare and offering tactical insights on how technology can help build loyalty by winning over patients. The full-day event is being strategically organized into two tracks to address the positioning of patients both as “consumers” and as “partners”. 

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Why St. Jude Children’s Research Hospital, The Mayo Clinic, and Leading Pharma and Medical Device Companies Have Digital Advisory Boards

By Sherri Douville, CEO, Medigram, @SherriDouville

Digital Transformation Is Hard For All Companies

In our work leading a digital health IT company, we are intrigued by the stated digital ambitions of leading health systems. We look at the actual path to execution for digital transformation. We are fascinated by this challenge, which affects all companies, including technology companies. Difficulty driving digital transformation is not unique to healthcare. For digital leaders, the ability to drive transformation shows how much leadership is actually required of their teams, together with their innovation partners to overcome the biases that digitally challenged firms will impose to defend against the changes of digital transformation.

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Message from the President

Hello HIMSS Chapter Members,

Welcome to the first edition of the Northern California HIMSS Chapter Newsletter for the 2016-2017 fiscal year. We have a newly assembled Board of Directors and volunteers that have been hard at work this summer planning and organizing phenomenal educational programs and networking events for our members. We have taken valuable feedback from our membership survey to cater our programs to meet the needs of this very large and diverse chapter, and have tailored our offerings accordingly.  

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Advocacy Committee Update

By Shanti C. Wilson and Ian Slade

With over 50 chapters across the United States, HIMSS helps connect members with local, state and national decision-makers on key Health IT (HIT) issues. For the Golden State of California, Northern and Southern chapters have come together, representing over 5,000 members, to create a unified voice to better address state-wide issues.

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Summer Social: Leading the Integrated Life

By Sherri Douville

Co-Chaired by Jason Johnson and Michelle Heimann, HIMSS NorCal hosted its Summer Social on July 21 at Rosenblum Winery in Oakland. When people think about Health IT, they might imagine a SysAdmin in a server room or a programmer working alone, staring into the computer screen. Health IT and the NorCal Chapter in particular boasts a broad, multidisciplinary membership, which includes health system executives, physicians, nurses, informaticists, consultants, vendors, IT professionals and others in the Health IT ecosystem who all bring different skills and backgrounds to the party.

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Asset Management: Data - The New Liquid Gold

A Data Governance Meetup Summary

By Sherri Douville

If you ask most health executives, they will tell you that they want their people to have access to timely and useful data for both clinical and customer experience purposes. HIMSS NorCal set out to identify what challenges have to be overcome to deliver on the promise of liquid gold, that data access. It turns out that for data to be meaningful, there has to be continual governance built around it. In this post, we aim to provide a useful talking point for you and your stakeholders to frame and set goals for your data management strategy. 

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Meetup Program

By Mariana Hu

The MeetUp Program is a very innovative and engaging way to promote education and networking in the HIT field. I joined as a new Director two months ago, and I am eager to continue growing this program that has already proven to be a huge success. I am pleased to share the upcoming events and good news.

Upcoming MeetUp Events
We are already confirmed for a MeetUp in Sacramento on October 13. This will be a great panel discussion on Driving Patient Engagement with Healthcare IT. RSVP now!

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Improvements to HIMSS Membership Analytics

By Andy Hilliard, CPHIMS

Did you ever wonder where NorCAL HIMSS members live, or which organizations they work for? The NorCAL HIMSS Board spends time each month reviewing membership demographics and trends in order to understand our membership and to tailor events and communications so that they are accessible and useful to as many members as possible.

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HFMA x HIMSS Presents: Introducing Five Pillars of Population Health Management Approach

By Naoko Okumoto

Mark your calendars for an exciting and educational webinar on Population Management jointly sponsored by your NorCal HIMSS Chapter and the Healthcare Financial Management Association.

Date: Tuesday, September 27 from 12-1PM
Speaker: Nandini Rangaswamy, MBA, Co-Founder, Executive Vice President, Chief Strategy Officer, Chairman of the Board.

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The NorCal HIMSS Education Committee Rocks!

By Margit Chapman

Chaired by Dr. Nik Tehrani, the Education Committee (EC) is very actively planning the 2016 education programs to fulfill the committee’s mission: To foster professional growth through education and collegiality among our members and allied healthcare professionals in the Northern California Region. This will be accomplished by offering events that prepare the members for professional certifications and advance their knowledge and skills in the management of healthcare information technology.

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Calling All Innovators

By Jim Bloedau, President Elect and Stevie Bahu, President

The annual HIMSS Leadership Exchange was held in Chicago recently. This meeting is open to all 55 chapters of HIMSS to learn and share best practices for moving to the next level of serving the membership. Stevie Bahu, our Chapter President, and I attended this highly respected event.  

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Message from the President

Dear Northern California HIMSS Chapter Members,

It is my pleasure and honor to accept the position of the incoming President for the Northern California Chapter of HIMSS for the 2016-2017 fiscal year. We have already begun planning and strategizing the events and programs coming up in the new year, and I am so excited for what we have in store. Our agenda for the year is filled with events providing exceptional educational content, networking opportunities, advocacy, and exploring the trendsetting technology that only the Bay Area can provide.  It is our commitment to our membership base, not only to provide cutting edge programs, but also to offer them in a variety of locations to accommodate our geographically diverse membership base. We have launched a MeetUp program this past year to accommodate those challenges. Please check our website for further details. 

The Northern California chapter of HIMSS will continue its mission to enrich the professional lives of our local members and community in a variety of ways. In a changing healthcare landscape, the Chapter continues to engage, understand and transform to meet the needs of its growing membership base. I welcome any questions, comments, or suggestions you may have to continue to improve our chapter. If you are interested in volunteering, we have a variety of opportunities available. Please feel free to e-mail for further information. It is an honor to serve this chapter, and I look forward to speaking with you at one of our upcoming events and programs this year. 

Best Regards,
Stevie Bahu
HIMSS Northern California Chapter 


40 NEW CPHIMS, 62% INCREASE IN CHAPTER - Shatters Previous National Participation and Exam Records!

By: Jim Bloedau, Innovation Chair, Education Committee Member and Board Member

On its first try at providing a CPHIMS review course and testing, the Northern California Chapter has set new records in class size, highest individual score (90%), highest class pass rate (78%) and same day testing (59) nationally.   A class split between April 6th and 7th at the Contra Costa County Health Services facilities in Martinez and the Northern California Chapter CPHIMS review course hosted April 8th at the University of San Francisco, Pleasanton campus, produced sixty-three CPHIMS review course participants with fifty-nine of those taking same day exams - obliterating the previous records held by the Southern California chapter!  It is anticipated that this will move the Northern California Chapter from tenth place in total CPHIMS to third nationally with one hundred and five CPHIMS. 

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Joint Team California (Both Northern & Southern)HIMSS is Honored by California Lieutenant Governor

By: Sherri Douville

Congratulations are in order to the joint effort of the Northern and Southern California HIMSS chapters and our advocacy teams. California State HIT day, which was held on May 25 was given a Certificate of Honor signed by Lieutenant Governor Gavin Newsom.

The Co-chairs of the event, Ian Slade Vice President, Advocacy, SoCal HIMSS, Martha Dameron, At-Large Board Member & Chair, Advocacy Committee, NorCal HIMSS, and Shanti Wilson, Co-Chair for the event together with John Petring, John Conklin, Michelle Heiman, and Danica Ramos planned an exceptional and educational day for HIMSS members in California.

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Engaging Patients in Population Health Across the Care Continuum

By: Dr. Robert Wilkov

The Patient Engagement committee had a very busy and successful year. It ran an outstanding series of Webinars starting in October, 2015. The webinars covered topics ranging from Patient Engagement, to Chronic Care Management, to Population Health. Webinars were well attended and set the stage for an outstanding event that was held at Stanford Event on April 5, 2016.

The webinars were run jointly with HFMA and the Bay Area Nursing Informatics Association. The webinars dealt with the following topics:

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What Does the Analogy of Money Ball Have To Do With Healthcare? – Analytics Literacy

By: Sherri Douville and Jim Bloedau
Made famous by the movie Moneyball, the Oakland A's EVP and minority owner Billy Beane used simple statistical analyses to develop winning teams – healthcare is going through the same evolution and will be one of the subjects covered in upcoming chapter events.

Planning for the 2017 Innovation and Showcase Conference and upcoming Meetups is well under way. Both the chapter’s Innovation Conference chair, Jim Bloedau and Meetup Program Director Jason Johnson are passionate about upgrading the attendees’ experience and content for both programs while optimizing the contributions to the professional growth of the membership.  

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President's Message What happened in Vegas… Was all about Healthcare IT from February 29 th though March 4th! The Northern California Chapter held several events, and enjoyed looking to engage our...
President's Message Happy Holidays from HIMSS Northern California! I have exciting news to share with our membership. HIMSS Northern California has been awarded the National HIMSS Chapter of the Year...
Hoala Greevy's blog about the September 30 Networking Event and Giants Game .
President's Message Welcome to our first HIMSS Northern California Newsletter! I am excited about all the things happening in Healthcare IT and excited to be a part of this first copy of our 2015...