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HIStalk Interviews Joel Diamond, MD, Chief Medical Officer of dbMotion

September 12, 2007 Interviews 3 Comments


A reader suggested that we might want to talk to Joel Diamond MD, chief medical officer for dbMotion, practicing family physician, and a former CMIO with UPMC. “You should try to interview Joel – he is smart and funny and really knows his stuff.”

Joel is working on an $84 million initiative to jointly create a healthcare interoperability model that will use dbMotion’s technology to connect clinicians across UPMC’s 19 hospitals and 400 outpatient sites and doctor offices. Thanks to Joel Diamond for sharing his thoughts with the readers of HIStalk.

Inga: OK, you ready to go?

Joel: Yes, though I am really nervous. Is this really Inga? [laughs]

[Laughs] Yes, but don’t be nervous. So, you do read HIStalk?

All the time. I am a huge fan.

So, you came from UPMC where you were CMIO. What led to your decision to move to dbMotion?

I have been following the interoperability plans for UPMC for a very, very long time ever since I was involved in establishing UPMC’s CPOE at one of UPMC’s remote hospitals. After the success of CPOE and other projects, it was clear that interoperability was the solution of the future. I dug in and learned about dbMotion. When I found they were looking for a medical director in the US, I jumped on the opportunity. dbMotion is great and it is a fun job.

Tell me about your position as CMO with dbMotion. What type of activities are you involved with?

The bulk of my work is this massive UPMC project, which has two separate parts to it. First, the core interoperability project itself. There is a lot of work to be done here in terms of customizing the physician views and integrating the multiple disparate platforms. The UPMC project itself is massive because we are trying to interface many, many disparate systems.

Also there is a joint development project between db and UPMC that is just getting off the ground. We are trying to develop a product to enhance patient safety issues. Trying to have the product reflect the needs of individual clinicians is one of our major goals.

In October, dbMotion and UPMC announced an agreement to create a joint development partnership. What is the scope of the project?

It is centered around a product called SmartWatch. SmartWatch is focused on looking at populations of patients and then being able to get lots of disparate data and then turn it into something actionable. For instance, we could define what child abuse might be and what to look for, and then put in certain parameters in order to monitor it. Patients with certain characteristics can be found and then you are able to report it to a particular organization or entity. Or it might involve bio-surveillance on a large scale.

We have a couple of use cases we are developing with UPMC. One of them involves transfer of care. When going from one venue to another, determining what needs to be done to ensure that the handoff is done properly and the patient information is collated properly. One of the other use cases is readiness assessment. If a patient has to schedule a procedure, then determining everything that needs to be done on an administrative level and making sure it is done. Third is chronic disease management and it will likely center around diabetes.

Are you involved with any of the international projects that dbMotion is working on?

No, because we have a CMO of dbmotion in Israel, Dr. Ran Goshen, who oversees all those projects.

What about any non-UPMC activities?

Dr. Diamond: Some with the Bronx RHIO project that is underway and has an expected go live in May of ‘08. I am also involved in the evaluation of new business opportunities in the US market.

Are you also visiting potential clients?

Yes, as well as trying to explore new areas where dbMotion might be needed other than what we have been focused on.

There have been a number of announcements over the last few months of RHIO efforts that have failed, either due to financial issues or lack of support from the community. Does that concern you?

It really doesn’t. It really isn’t a surprise. If you look at the Gartner’s Hype Cycle, we are at the Trough of Disillusionment. There had been some unrealistic expectations. We are now much more realistic about what RHIOs can do.

I am not pessimistic about RHIOs all. I think our focus will change a little bit. A lot of people set out to do RHIOs, but didn’t have the technology to do it. I think that is where dbMotion makes a difference.

Who does dbMotion see as competitors?

A lot of people are in the so-called interoperability space, but we don’t necessarily see them as competitors because they have a very different focus than us. A lot of people are in the portal space and that is more of a forum to view information. There are several companies trying to collect data to see in a single space. dbMotion is different because we have the Unified Medical Schema and we are focused on aggregation and integration of data.

So, explain to me how dbMotion is different than a company like Healthvision?

dbMotion has very, very unique architecture that allows it to handle a lot of the complicated interoperability issues in a very, very short time. It has a broad and deep reach. We are not a product that just has the ability to point you to the information you need or just display data you need.

In a true schematic operability, you can exchange information because they have a common understanding. You may link up a disparate system that has different terminology for the same diagnosis. We have the ability to take the data and present it as a single common knowledge piece and do whatever needs to be done. It can be used by an individual in a format that is meaningful.

The other thing that is different is that if you are just presenting data, it becomes a very huge list for people to scroll through. A large data dump may discourage users from using it. Looking at a list of allergies, you may overlook important data if you don’t present the information in a format that is relevant to the physician. Our technology allows the information to be displayed in a more meaningful format. It also helps with patient safety.

Why are UPMC’s interoperability projects surviving?

There has been a tremendous vision from the start. In addition to that, the people involved in the project, from IT to doctors and nurses, have really kept the focus on the entire project more on a quality. So, focus plus talented people, and then they keep building on their successes. They have also had a very steady and well-constructed ambulatory project for EMRs that has allowed for integration of all the data, along with a goal of improving patient safety.

So the goals are good and people are good.

Yes, and they haven’t been afraid to change their course when appropriate. They realized at some point that having a one-size-fits-all model was not going to be sustainable. At that point, they realized they needed multiple solutions and needed some central ability to control the processes. And that is when the decision was made to partner with dbMotion.

I understand that in addition to your work with dbMotion you are still seeing patients. How do you balance your dbMotion work and your clinical activities?

Yes, I am still seeing patients. I am balancing it very carefully. [laughs] I need to maintain seeing patients on a personal level because I enjoy it so much. And, two, without seeing patients, I am not sure I can maintain credibility and an understanding of physician needs.

Having an EMR for so many years provides me access to my patients’ information in so many ways. I have a patient portal and use e-prescribing. Many of my patients I have known for years have access to me by cell phone 24×7, so my situation doesn’t mean they have any less access to me. I work one full and very long day in the office seeing patients.

You spent some time working with Misys in an advisory role for their EMR and CPR products. Any thoughts on the recent changes, including selling off the hospital pieces and re-selling the iMedica product?

I have mixed emotions on the CPR sale. I think it will help their focus. There were so many great people associated with that product. I think it was one of the best products I had ever seen.

I can’t comment on the business reasons and whether it was a good decision. But the product isn’t going away, so that is good. And, I wouldn’t know enough about the iMedica situation to comment about it at this point. I will say that Misys’ focus on the community is a very, very smart play.

Who do you admire in the industry?

Hmmm… Mr. HIStalk and Inga? It is a very, very long list after Inga and Mr. HIStalk.

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Currently there are "3 comments" on this Article:

  1. Great interview! A follow-up question for Dr. Diamond – how is your product really different from 3M’s Clinical Data Repository with the configurable workstation, health dara dictionary, and alert writer? The biggest difference seems to be that your front-end is web-based and that in addition to a patient-centric alert, the product also provides population-centric alerts (bio-surveillance). Their product replicated the data and stored it to a standard data model via the health data dictionary, could send an interface back-out if you would like, and had the alert writer (albeit for more patient centric as opposed to population-centric rules).

  2. Fantastic interview!!! dbMotion and UPMC have a lot to feel good about given Dr. Diamond’s vision. This gentleman is certainly going to continue to make headlines in HIT! Dr. Diamond is clearly one of the most intelligent leaders in our industry. WOW!!!

  3. To Art–
    First of all, let me congratulate you for your fantastic HISTalk
    interview. I wanted to respond to your ever inciteful commentary and
    question. While we don’t comment on specific competitors in the public
    domain, I would like to answer your question in a general sense by
    pointing out that the dbMotion product is unique in that it is one of
    the only solutions on the market today which addresses the
    interoperability problem in an end-to-end manner. Other products can
    provide partial solutions, such as a centralized patient view (portal),
    messaging, or result delivery. dbMotion, on the other hand, provides a
    complete platform that doesn’t stop there– it goes a few steps further
    by enabling its customers to maximally leverage their existing IT
    infrastructure to address current and future needs. Our SOA
    architecture and sole focus on interoperability allows us to address all aspects of
    this complicated arena, including security, vocabularies and semantic
    knowledge. We often find that alternative solutions involve assembling
    together a set of tools which are normally sold and thus often operated
    independently. Even then, most companies still need to add components
    from external vendors to provide necessary functionality. We also pride
    ourselves in the fact that our solution is pragmatic in that it was
    built to serve imperfect environments– not just those that have ideal
    interfaces and harmonization of technologies.
    oel Diamond, MD, FAAFP
    CMO, dbMotion North America

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