Imagine this: Your company has just won a contract with the U.S. Department of Health and Human Services to oversee the development of a software project. It’s on behalf of a brand new initiative: the Federal Health Architecture program, led by the Office of the National Coordinator for Health Information Technology. Now comes the hard part: putting together a software development team within five days. Not working days. Calendar days.
For some, a mission impossible. For Jim Traficant, vice president of Harris Healthcare Solutions, just the opportunity he’s been waiting for.
Since winning the HHS contract in March 2008, Traficant and his team have shepherded the development of the software, CONNECT, which enables federal health agencies and commercial providers to more quickly and easily, share patient information through the Nationwide Health Information Network (NHIN). The end goal is simple: to improve overall care and reduce costs.
Project results have been swift, nearly from the get-go. Less than four months into the project, Traficant’s team released a first version of the software to the Social Security Administration. Federal Health Architecture (FHA) leaders have since enlarged the scope, calling for open source availability. Traficant’s team has obliged, overseeing the release of an updated version, with increased functionality and enhanced security, every three months — a remarkable feat, given that most government projects see a software release on a yearly basis, six months if they’re lucky.
Along the way, Traficant and the healthcare team he leads at Harris, are helping to transform the very nature of healthcare — in particular, the dramatic role government contractors can play in helping Office of the National Coordinator (ONC) implement a framework for effective healthcare delivery. Traficant credits the “visionary behavior” of federal agencies — ONC and the FHA program, especially — with the fast-paced results.
Others also credit Traficant. Among them is David Riley, CONNECT initiative lead for the FHA program and owner of Enaptics Consulting. “This isn’t my first government software project,” Riley said, “and I can tell you it requires leadership on the government side, and on the contractor’s side … There’s no doubt that the success of the project is largely due to Jim’s leadership, the way he’s brought the team together.”
To understand Jim Traficant’s passion for healthcare IT, you have to go back to the beginning: to a hospital room, at Johns Hopkins Medical Center.
It’s November 1999, and Traficant is recovering from surgery. Four months earlier, he became the fifth individual to receive an adult living-donor liver transplant at Johns Hopkins — and the first where the patient and donor weren’t related. From his hospital bed, he turns on the TV one night to learn that NFL Hall of Famer, Walter Payton of the Chicago Bears, has just succumbed to a rare autoimmune liver disease — the same disease Traficant is battling this November day.
What follows is an 11-year journey to help change the face of healthcare.
Up until then, Traficant had been a successful government contractor within intelligence, as well as in spacecraft command and control missions. Now, he was about to apply his technology and business background toward healthcare.
“After two life threatening [transplant] rejection episodes, I started to study my blood work and medications,” said Traficant, who calls surgery a science, medicating an art. “I could see, even in my own case with outstanding clinicians, there was a lack of critical information, particularly at the point of care and decision.” Working with doctors, he devised an algorithm to predict when a rejection might occur. That’s when he realized: “Healthcare has data. What’s missing is information. If you could get the right information, to the right person, at the point of care — you could improve care, lower cost, and save lives.”
From that personal mission, something larger was born: a great corporate mission. The tipping point was a second liver transplant he received in November 2005, following a near-fatal bout of septic shock. Traficant approached his employer, Harris Corporation, an international communications and information technology company, about starting a healthcare IT division. Traficant recalled that moment: “I knew that Harris had a unique ability to manage information … we were trusted at the intersection of life and data in the intelligence community, in the FAA, and in the Department of Defense. If we could translate that same notion of situational awareness to healthcare, we could make a difference there, too.”
That vision proved contagious, especially in assembling a team. “It was a pretty easy choice for me,” said Tony Galluscio, who’d worked with Traficant 15 years before, at a software technology company. “I started working for Jim right out of school,” he says, “and I was always impressed with his determination and ability to understand the market’s needs.” Today, Galluscio serves as Harris NHIN CONNECT program manager.
Additional industry partners were quick to get on board. “From day one, a contract is like a courtship,” said Riley, FHA’s CONNECT initiative lead. “The government frequently has a rough idea of what they want but they typically don’t know the details,” he said. “Having a software development process that’s agile and flexible, in real time, with short development cycles — so that if you aim small, you miss small — is essential.”
Riley credits Traficant on all fronts. “It was clearly Jim’s choice of the technical lead, Tony Galluscio, and the partners that he brought to the table … pulling that all together requires somebody with a strong sense of vision of where they want to go and the capabilities they want to provide.”
Today, Harris Healthcare Solutions stands as a leader in healthcare IT development.
The group’s oversight of CONNECT is a big reason why. SSA was the first federal agency to go operational with the software. The results have been tangible. The time spent accessing health records to determine benefits to veterans has shrunk from 83 days to mere seconds. “We think those are the kind of ingredients for healthcare transformation,” Traficant said.
CONNECT is also furthering another essential ingredient: collaboration among federal agencies. By September 2008, the FHA program, leveraging the software, was able to demonstrate interoperability among SSA, Department of Defense, and the Department of Veterans Affairs with 16 other federal agencies. By December, three additional agencies — Centers for Disease Control and Prevention, Indian Health Service, and National Cancer Institute — participated in demonstrations at an NHIN trial implementation event.
More strides followed. By February 2009, SSA and, later MedVirginia, went into live production with NHIN, using CONNECT. Then, in April, President Obama announced that Military Health System (MHS) and the VA would aggregate health information into a common record, the Virtual Lifetime Electronic Record. Again, CONNECT undergirds that effort.
Equally significant, CONNECT has been used to link private and public sector networks — a critical task given that more than half of healthcare delivered to active duty and retired service members comes from the private sector. Recently, MHS and the VA engaged in a pilot study with one of the largest providers, Kaiser Permanente, to exchange records information through CONNECT.
Commercial providers are increasingly demonstrating interest in the technology, particularly in the wake of meaningful use standards. About a year ago, FHA released the code as open source. So far, there are more than 1,000 subscribers in the CONNECT community, including software developers from large and small companies, health networks, vendors, and universities. Many now comingle with federal and state agencies at FHA conferences, such as CONNECT Code-A-Thons, in which interested parties meet on a quarterly basis to gauge how open-source CONNECT tools can securely foster healthcare information exchange.
All of which pleases Traficant. “I’ve been in government contracting for over 20 years,” he said, “and I think it’s unprecedented, the degree of collaboration we’re seeing across multiple federal agencies, and now, increasingly, with the private sector — this broad context will be a foundational element to creating national healthcare reform.”
“Everybody Has a Story”
In many ways, the success of Harris Healthcare Solutions points to one thing: Vision. Personal vision. Born of a moment of reckoning. Several years ago, when Jim Traficant emerged from septic shock, he had to begin the journey forward, most basically, by learning to walk again. First came a wheelchair, then a walker. “I could never have imagined getting to work again, let alone getting to do something that is so fantastic. ”
This isn’t just his story, though. Like any leader, Traficant is helping others find that shared passion, for a common mission. “Everybody has a story,” he said. “We’re getting experts from across industries — folks out of the Intelligence Community who are literally national assets — saying, ‘My mom has cancer and I would like to take the things that I’ve been able to deploy in one context and move it into healthcare.’”
Harris Healthcare Solutions is also securing contract wins in additional areas. Among them is a three-year $72 million contract to support expansion of the VA’s consolidated billing and collection services. Plus, a 10-month, follow-on contract by a prime contractor, Evolvent Technologies, to offer ongoing enhancements to a military health network between the VA and other medical centers.
Meanwhile, Traficant is feeling great. “I typically say that the two best days in a person’s life are the day you’re born and the day you know why,” he said, adding, “I’ve gone through a difficult time physically but when I wake up in the morning I’ve got clarity about the things that matter … the chance to work in healthcare is a privilege I couldn’t have imagined.”
CONNECT: What’s Next
On the federal side, agencies are continuing to leverage the software. SSA, for one, is in the process of increasing its information exchange by 14 additional organizations over the next 18 months, said Riley. Then, there’s a larger issue: the healthcare reform bill. “Obviously, we’re still trying to understand where we’re going with that,” he said. “CONNECT will be critical in addressing these larger issues.”
An interim step is to add another dimension to CONNECT, focused on meaningful use. “We’ve been able to make the data reliably available; now we’re working to make it usefully available,” said Galluscio. That means creating the means for adaptability to systems that already exist. “We’re working on providing a platform for participation, where providers, payers, and anyone associated with healthcare who needs health information can do so in an interoperable, meaningful way.”
At the same time, open-source development continues, in a predictable fashion — just as it has over the last seven releases. Throughout, Traficant is keeping his eye on the mission. “The real charter of CONNECT is to build out the NHIN specifications and implement them in a way that the community can broadly adopt, and embrace, in an open source context,” he said.
Still, Traficant and his team aren’t resting on their laurels. “We want to celebrate our successes but not rest on our laurels,” he said. “Continuing to keep the intensity, the focus on collaboration, and extending it out to more players — both federal and industry — will be fundamental.”