SSA's Jim Borland on Healthcare Information Technology

Today, on this week's Federal News Radio Federal Executive Forum webcast, Mr. Jim Borland, Special Advisor for Health IT, Office of the Commissioner, Social Security Administration
(SSA), will discuss the value of health care information technology. His comments included the following:

• Every disability benefit claimant must have their medical records reviewed. Once the claimant authorizes medical record release, they are typically received by fax today. Fifteen million request for medical records from over 500,000 physicians and 6000 hospitals are processed every year.
• Health care information technology offers a tremendous opportunity to improve and automate the collection of medical records and to use decision support tools to analyse those records before a human looks at them.
• Improved health care IT will give the SSA the ability to make claims related decisions faster, dramatic reducing required processing time by up to one-third.
• A key challenge is for us to identify data standards that can be used across multiple different business processes.
  
  
  
  
  

The Federal Executive Forum panel participants are:

• Vish Sankaran- Program Director, Federal Health Architecture, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services (HHS)
• Linda Fischetti- RN MS, Health Informatics Architect, Future Health Systems Design and Usability, Health Information Architecture, Veterans Health Administration
• Dr. Leslie Lenert- MD, MS, FACMI , Director of the National Center for Public Health Informatics (NCPHI) at the Centers for Disease Control and Prevention (CDC)
• Jim Borland- Special Advisor for Health IT, Office of the Commissioner, Social Security Administration (SSA)
• Tom Simmons- Area Vice President for Federal Systems, Citrix Systems
• Ken Rubin- Chief Architect, EDS

The complete panel discussion will be available via a Federal News Radio webcast starting today, Thursday, June 25th at 2pm (http://www.federalnewsradio.com/?sid=1692826&nid=50). There is no charge for this event. To receive an email reminder two hours before the webcast starts, please register.

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Dr. Leslie Lenert of CDC Speaks on Healthcare IT

During this week's Federal News Radio Federal Executive Forum pre-recording, Dr. Leslie Lenert, Director, National Center for Public Health Informatics (NCPHI) at the Centers for Disease Control and Prevention (CDC), shared some of his thoughts on the future of health care information technology. His comments included the following:

• The NCPHI is focused on (1) improving the link between public health and our national clinical care systems and (2) automating public health practice.
• The biggest change in health care information technology is the establishment of two-way
  communications between public health and the health care system.
• Health situational awareness is crucial to our ability to monitor public health problems. We must target situational awareness so that it makes a difference in individual patient care.
• One key to addressing privacy and confidentiality concerns is for us to move away from "individual level" information exchange unless it benefit the specific patient. We should be focused on summary level data exchange.
• Coordination models that allow collaboration across regions are important in helping us identify and disseminate best practices through Public Health Information Network (PHIN) communities of practice.

The Federal Executive Forum panel participants were:

• Vish Sankaran- Program Director, Federal Health Architecture, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services (HHS)
• Linda Fischetti- RN MS, Health Informatics Architect, Future Health Systems Design and Usability, Health Information Architecture, Veterans Health Administration
• Dr. Leslie Lenert- MD, MS, FACMI , Director of the National Center for Public Health Informatics (NCPHI) at the Centers for Disease Control and Prevention (CDC)
• Jim Borland- Special Advisor for Health IT, Office of the Commissioner, Social Security Administration (SSA)
• Tom Simmons- Area Vice President for Federal Systems, Citrix Systems
• Ken Rubin- Chief Architect, EDS

The complete panel discussion will be available via a Federal News Radio webcast starting Thursday, June 25th at 2pm (http://www.federalnewsradio.com/?sid=1692826&nid=50). There is no charge for this event. To receive an email reminder two hours before the webcast starts, please register.

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Linda Fischetti on VHA Healthcare

This week pre-recording of Federal News Radio Federal Executive Forum featured Linda Fischetti , Health Informatics Architect at the Veterans Health Administration (VHA). During a panel discussion, her comments on VHA accomplishments and plans included:

• Every Veteran's Administration facility uses electronic health records today. The New England Journal of Medicine recently complimented the VA on their use of electronic
  health records (EHR).
• VHA currently has over 1400 points of care and has been using EHR for over 10 years with dramatic associated improvement in clinical health care quality.
• Until now, electronic health records have been provider records. The current goal is to
  transform that perspective into a veteran centered record.
• A majority of health care information is currently recorded on paper. Changing from paper to EHR represents a major challenge and expense. Clinicians must be drivers and decision makers in this health care information technology transition.
  

The Federal Executive Forum panel participants were:

• Vish Sankaran- Program Director, Federal Health Architecture, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services (HHS)
• Linda Fischetti- RN MS, Health Informatics Architect, Future Health Systems Design and Usability, Health Information Architecture, Veterans Health Administration
• Dr. Leslie Lenert- MD, MS, FACMI , Director of the National Center for Public Health Informatics (NCPHI) at the Centers for Disease Control and Prevention (CDC)
• Jim Borland- Special Advisor for Health IT, Office of the Commissioner, Social Security Administration (SSA)
• Tom Simmons- Area Vice President for Federal Systems, Citrix Systems
• Ken Rubin- Chief Architect, EDS

The complete panel discussion will be available via a Federal News Radio webcast starting Thursday, June 25th at 2pm (http://www.federalnewsradio.com/?sid=1692826&nid=50). There is no charge for this event. To receive an email reminder two hours before the webcast starts, please register.

Vish Sankaran, HHS, Speaks on Healthcare IT

During the pre-recording of this weeks Federal News Radio Federal Executive Forum, Vish Sankaran, Program Director of Federal Health Architecture, discussed the role of information technology in improving the country’s health care system. These dialogue was great for healthcare management professionals and anyone else in the industry.  Mr. Sankaran insights on the Obama administration efforts in this area included:

• Significant progress has been made in the coordination of efforts between agencies with a health related mission. A clear sign of progress is the coordination between 25 different agencies in establishing the federal health records gateway
• Since it's release in February, the federal health records gateway has received over 46,000 unique hits and over 1300 downloads
• The biggest opportunity we have in health IT today is enabling information to follow the patient, which helps doctors to make better decisions
• Historical challenges around proprietary systems are now being overcome through active participation from the vendor community and the establishment of interoperable open specifications
• A key challenge that needs to be addressed is how to rectify the more stringent FISMA requirements (with approximately 170 controls) with the less restrictive HIPPA regulations (with about 70 controls)

The Federal Executive Forum panel participants were:

• Vish Sankaran- Program Director, Federal Health Architecture, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services (HHS)
• Linda Fischetti- RN MS, Health Informatics Architect, Future Health Systems Design and
  Usability, Health Information Architecture, Veterans Health Administration
• Dr. Leslie Lenert- MD, MS, FACMI , Director of the National Center for Public Health Informatics (NCPHI) at the Centers for Disease Control and Prevention (CDC)
• Jim Borland- Special Advisor for Health IT, Office of the Commissioner, Social Security Administration (SSA)
• Tom Simmons- Area Vice President for Federal Systems, Citrix Systems
• Ken Rubin- Chief Architect, EDS

The complete panel discussion will be available via a Federal News Radio webcast starting Thursday, June 25th at 2pm (http://www.federalnewsradio.com/?sid=1692826&nid=50) . There is no charge for this event. To receive an email reminder two hours before the webcast starts, please register.


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Iranian Protests Showcase Twitter, Facebook, YouTube (and Cloud Computing) !

In covering unfolding events in Iran, the world's most powerful news outlets have been entirely dependent on the Twitter-provided flow of text, images, and video. While this has definitely showcased the power of Twitter, Facebook and You Tube as an information channel, it also prompted me to re-read some of my September 2008 blog posts:

9/9/08 The Cloud Wins in Minneapolis at the RNC!

• Little did I know that while I was watching the Republicans cheer their standard bearer inside the Xcel Energy Center that the cloud infrastructure was outside defeating the forces of civil obedience!
• From "The revolution will be Twittered": "A free and public social-media website called Twitter, which publishes brief messages sent in from cell phones and computers, was a game-changer for protesters, organizers, and journalists covering the event. ....What developed was an ad hoc information system that provided a vast amount of first-hand accounts, insight and the opportunity for rumors and misinformation."
• This wouldn't be possible without wireless connectivity, a virtualized IT infrastructure and open source application technology. In short, it wouldn't be possible without the underlying cloud computing technologies.

9/10/08 Ambient Awareness. The cloud killer app?

• In the September 5th New York Times article, "Brave New World of Digital Intimacy", Clive Thompson really got me thinking about how cloud computing, social networking sites like Facebook and adhoc information networking tools like Twitter are combining to mold our future social interactions.
• This social transformation may also provide new tools to address situational awareness requirements within the national security community.While a Twitter stream of consciousness may, on the surface, seem useless, the paradox of ambient awareness may make such technologies incredibly useful.

9/23/08 Google, GeoEye, Twitter. What a Combination!

• According to their press release, GeoEye-1 will be able to collect images with a ground resolution of 0.41-meters or 16 inches in the panchromatic, or black-and-white mode, and collect multi spectral, or color imagery, at 1.65-meter resolution. (Under current government rules, the company can only offer the public half-meter images.)...
• All you need now is some real-time queuing from a Twitter-powered ad-hoc information network and you really got something going.

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Two Days with AWS Federal

Today, I start two days of training with Amazon Web Services (AWS) Federal. If that's the first time you've ever heard about an AWS Federal division, your not alone. Held in downtown Washington, DC the course was invite-only and attendance was IT services firms that had demonstrated a clear track record of success in the Federal market. The companies invited to this inaugural session were:

o Abacus Technology Corp (http://www.abacustech.com)

o Acumen Solutions, Inc. (http://www.acumensolutions.com)

o Apptis (http://www.apptis.com)

o Citizant (http://www.citizant.com)

o CNSI (http://www.cns-inc.com)

o Collabnet (http://www.collab.net)

o Dataline (http://www.dataline.com)

o Foxhole Technology (http://www.foxholetechnology.com)

o IGI (http://www.igius.com)

o Information Concepts (http://www.infoconcepts.com)

o SE Solutions (http://www.sesolutions.com)

o Syneractive (http://www.synteractive.com)

o Touchstone Consulting Group (http://www.touchstone.com)

o Turner Consulting Group (http://www.tcg.com)

From the AWS point of view, the stated objectives were to provide a high level overview of AWS, share their technology roadmap, develop joint sales/marketing strategy with key partners and to build stronger relationships within the Federal marketplace.

Personally, this was the first time I had ever heard the seminal AWS question: Do we have to start from 1st principles every time? In retrospect, this view really makes sense. AWS focuses on the "undifferentiated heavy lifting" letting their customers focus on their business - "differentiated value creation". This was also the first time I had heard of the "70/30 switch". Traditionally, up to 70% of an organization's IT resources are dedicated to necessary and mundane grunt work:

• hardware management
• software management
• maintenance
• load balancing
• scaling
• utilization
• idle machines
• bandwidth management

AWS optimizes the grunt work and enables the switch, allowing their customers to focus that 70% on value creation.

The morning session focused on describing the various AWS services. Some key points included:

• Nothing on the AWS platform is language or technology dependant. Strings and HTTP seem to be the basis of everything
• AWS offers application and operating system level visibility allowing customers to use their own application and/or operating system level monitor and scale solutions
• Licensing software on AWS is dependant on the software provider. Microsoft won't let you bring your company's licenses into the cloud. Oracle and IBM, on the other hand, will let you put all your licenses on the cloud platform.
• Software that binds itself to specific hardware can still be a problem.
• Stay tuned for some exciting innovations around developer account capabilities (Account and subaccount availability)

The afternoon session did a deep dive on security. Yes, their system is secure. In the end, technology is not an issue. Within the Federal space the question is policy on the government side and a valid business case on the Amazon side.

(6/19 Update: In response to reader comments, security depends on the metrics an organization is required to meet. My statements on AWS security is not valid for all potential implementations.)

I would like to thank Carl Moses, Eric Lee and Kevin Kelly for today's welcomed and insightful session. The (unofficial) existence of AWS Federal is exciting news. I can't wait to learn more tomorrow.

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Maneuver Warfare in IT: A Cheerleading Pundit

The Twitter conversation between Christofer Hoff and I went like this:

Christofer - I haven't formally blogged a resp. (yet) to @Kevin_Jackson on his 'maneuver warfare in IT' Not just a cultural shift but a huge tech. one

Kevin - @Beaker I'm looking forward to your comments.

Christofer -  @Kevin_Jackson I want them to be constructive, so I'll do my best. I'm having trouble with the reality distortion field vs. unicorns ;)

Kevin - @Beaker LOL

I strongly recommend that you read his response titled "Cloud Computing Security: (Orchestral) Maneuvers In the Dark?". It begins:

"I enjoyed Kevin’s piece but struggled with how I might respond: cheerleader or pundit.  I tried for a bit of both."

The challenges he had with my article, include:

• Mixing tenses in some key spots seemed to imply that out of the box today, Cloud Computing can deliver on the promises Kevin is describing now.  Given the audience, this can lead to unachievable expectations
  
• The disconnect between the public, private and military sectors with an over-reliance on military analogies as a model representing an ideal state of security operations and strategy can be startling
  
• Unrealistic portrayals of where we are with the maturity of Cloud/virtualization mobility, portability, interoperability and security capabilities
  

His last couple of paragraphs, however, really brings it home:

"It’s absolutely a cultural issue, but we must strive to be realistic about where we are with Cloud and security technology and capabilities as aligned.  As someone who’s spent the last 15 years in IT/Security, I can say that this is NOT the “…dawning of a new day in IT security,” rather it’s still dark out and will be for quite some time.  There is indeed opportunity to utilize Cloud and virtualization to react better, faster and more efficiently, but let’s not pretend we’re treating the problem when what we’re doing is making the symptoms less noticeable.

I am absolutely bullish on Cloud, but not Cloud Security as it stands, at least not until we make headway toward fundamentally fixing the foundational problems we have that allow the problems to occur in the first place."

Please read his post and comment.  This is a GOOD conversation !!

Expanding Maneuver Warfare in IT

Earlier this week I published "Cloud Computing: The Dawn of Maneuver Warfare in IT Security" via Ulitzer. In publishing the article my intent was to explore the more dynamic approach to information security offered by cloud computing. Although the conversation continues in earnest, today I would like to highlight Ben's thoughts from Iron Fog:

"What about managing virus outbreaks, patch deployment and vulnerability detection?

managing virus outbreaks - If I can scale my security infrastructure rapidly, I can scan my distributed filesystem and workstations, I can hunt down and remove infections - in theory I can scale my cloud rapidly enough to combat warhol-esque worms.

patch deployment - if I need to force patches across my environment, I can deploy a swarm of servers that will connect to every server and workstation in my enterprise and force the patch down (after I've spun up a multiple VM's to test/socialise the patch against my standard configurations).

vulnerability detection - Scanning a class B sized network can take a while, but what if I can launch a few hundred servers and ask them to scan a less than a class C each, in parallel (note: this idea wasn't mine, credit to Richard at Enomaly) - I can get near-realtime vulnerability intelligence on my environment at relatively low cost. Running a few hundred EC2 servers for less than an hour is pretty cheap, especially if compared against buying a whole bunch of expensive scanning appliances (then again, there's nessus)."

These examples are perfect extensions on the idea of maneuver warfare in information technology.  His post also brings up some concerns that need to be addressed.  Let's keep the ideas coming.

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Vivek Kundra to Speak at NRO Showcase

On the 17 & 18 June, the National Reconnaissance Office (NRO) will present the premiere Innovative Solutions Showcase. Titled "Unleashing the Crowd in the Cloud: Igniting the Innovation Insurgency", this event will be held at the NRO in Chantilly, Virginia. The theme will focus on collaboration and information sharing with an emphasis on innovation and mission-enabling applications that address challenges and opportunities across the National Security Enterprise.

According to the event website, the current rise in the use of Web 2.0 social media has spawned innovative and unorthodox approaches to meet the demands of today's global and highly mobile workforce. The data-driven web has morphed into a user-centric web, with increasingly empowered users who are accustomed to and demand self-service and highly customizable experiences. An expected highlight will be a demonstration of "Apps for Democracy" by Vivek Kundra, Federal CIO.

Other speakers include:

• Mr. Rob Zitz Director of NRO's NGA Support Team and Director of DDMS RRIO
  
• Ms. Michele Weslander Quaid NRO CTO
  
• Dr. Vint Cerf Google
  
• Mr. David Stephenson  Author of Democratizing Data
  
• Dan Risacher OSD-CIO/NII
  

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Secure Cloud Computing on Federal News Radio

Last week the Trezza Media Group, Flyzik Group and Federal News Radio combined to produce an outstanding Federal Executive Forum on Secure Cloud Computing. Moderated by Jim Flyzik, panelist included:

• Henry Sienkiewcz-Technical Program Director, Computer Services, Defense Information Systems Agency 
• Mr. Ronald Bechtold-Army Architecture Integration Center, at Headquarters, Department of the Army, Chief Information Office/G6 
• Curt Aubley-Technology Officer CTO Operations & Next Generation Solutions, Lockheed Martin Information Systems & Global Services
• Dale Wickizer-Chief Technology Officer-Public Sector, NetApp, Inc.
• Aileen Black- Vice President of Public Sector, VMware Inc.

Key points I gleaned from the discussion include:

• Cloud Computing has provided an inflection point in government information technology that is changing the paradigm for delivering services
• The biggest challenge to adopting cloud computing is in re-educating the workplace. 
• The reduction is cost and increase in efficiency have proven to be key to the success of cloud computing
• DISA has shown that a STIG'ed or Non-STIG'ed, Windows or LAMPs, test and evaluation  environment can be provisioned in the DoD in 24 hours. Unfortunately, 23 of those hours involves moving the money.
• A new DISA project, DISA Extended Edge Presence (DEEP), has been launched in order to quickly deliver applications and content to "dis-enfranchised" DoD users
• Cloud computing allows for end-to-end infrastructure visibility, providing an ability to fight through a cyber attack.
• DISA is developing a host-tenant model for applications and application certifications.  Using this model, tenant application in "DISA decks" will inherit the infrastructure certification. Using this model, the application developer will only be responsible for accrediting the application stack.

Video and audio of the entire discussion is available online at:

 http://www.federalnewsradio.com/?sid=1662577&nid=50

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