The Right Information at the Right Time: A Chat with Justin Lanning

President and chief executive officer of CredenceHealth and president of the Tennessee chapter of the Health Information Management System Society, HIT Exchange editorial board member Justin W. Lanning has a proven track record in helping clients achieve optimal performance and maximize their investment in information technology. He brings years of experience to HIT Exchange as a business, product, technology, strategy, and innovation leader in health care.

Prior to CredenceHealth, Justin served as a key leader for Healthways, Inc. in Nashville, Tenn., where he was responsible for building multiple organizations to meet the company's many high growth needs. Justin was also responsible for operations, solutions, and technology strategies and innovation as well as for guiding customer relationships.

Justin recently spoke with HIT Exchangeabout the marriage of evidence-based clinical research and real-time clinical data, the importance of collaboration between strong clinical and technological leaders, and some of the challenges involved in bringing new HIT solutions to market.

Q: What is the state of electronic medical records (EMRs) today?

A:It's in flux. Some hospitals are just getting started and others are very advanced, which creates a national challenge. We have to figure out how we are going to meet their needs. Lawmakers need to consider what funding should be given to hospitals that are just getting started versus ones that have already implemented steps to achieve the requirements. In other words, how do we keep the rich from getting richer and the poor from staying poor? One of the first steps I've seen as part of the American Recovery and Reinvestment Act (ARRA) has been the loosening of some of the meaningful use rules. Early on, the requirements were challenging enough to provide a disincentive for some hospitals to even strive toward the goal. Now, I think the ground is becoming more level.

Q: What are some of the biggest challenges in bringing new HIT solutions to market?

A:The mix of evolving requirements and the overwhelming number of changes and new products clinicians have to absorb in such a short period of time can be daunting. We have to streamline these technologies and really understand what users want, need, and will use. I think that's the most critical barrier to all of this.

Q: What are some of the challenges to getting buy-in from users?

A:What we're doing is asking people to completely change the way they work and adopt a new technology. The technology needs to start with version one. Let's meet the clinicians where they are and get them familiar with these technologies, and then we can grow from there. There weren't a thousand iPhone apps when the iPhone first came out. There were just a few. As people adopted the iPhone, the selection grew. The high bar that was initially set with this legislation assumed that people would be able to make a leap.

Q: What role does cost play in all of this?

A:Money is one of the barriers on the list, but it's not the most critical. It's a big issue right now because it's very difficult to point to a demonstrable return on investment (ROI) that says that an EMR makes you noticeably more efficient or that it drastically reduces cost.

Q: How long do you think it will be before all hospitals across the country are EMR-compliant?

A:I think the electronic aspect of EMR is less of a worry than meaningful use. Meaningful use has nothing to do with technology at all. It has to do with how long it will take users to adopt the technologies and actually work with them in a meaningful way. The technologies aren't where they should be right now. Some nice emerging technologies out there are bringing real-time information to folks, but the overall technology is still not quite there. I think we're going to evolve over, say, a decade. When telecommunications went through its reform, it took about 13 to 15 years. If you look at the reform of the steel and banking industries, it was not a two- or three-year type of thing. So, I think we're looking at a hefty timeframe. The most important factor in this transformation is the collaboration between strong clinical and technological leaders who understand how to consume and remain committed to the change management process.

Q: When did you begin to realize the potential benefits of layering evidence-based clinical research on top of real-time clinical data?

A:When I was at Healthways, which is the nation's leading-and largest-wellness and disease management services company, I became aware of and passionate about the value and importance of having the right clinical information at the right time.

Q: How did you decide that this particular area would be the most effective use of your daily innovative efforts?

A:We had key goals in mind when we started CredenceHealth, and the right team to make it happen. We wanted to accomplish three things: first, help clinicians keep up with the unprecedented changes in research; next, provide clinicians with the latest predictive and real-time intelligence and surveillance on emerging complications and compliance risks; and lastly, address the challenge of actionable, timely, and efficient accessibility to clinical information with HIT systems. We do the heavy lifting by providing a solution that requires no additional hardware and minimal effort from the hospital IT team.

Q; Which of your HIMSS chapter's contributions to regional healthcare IT education and adoption make you most proud?

A:Hosting premier current education via the Summit of the Southeast and the East Tennessee Summit events have been high points. These events draw more than 700 attendees each year combined.

Q: How do you aspire to direct or shape the national HIT conversation along with other HIT Exchange editorial advisory board members?

A: By continuing to encourage and enable open collaboration between public and private HIT professionals, I aim to ensure our policies and funding supports and results in truly self-sustainable business models that provide meaningful ROI.