Lalo Valdez is president and CEO of Stella Technology of Sunnyvale, CA.
Tell me about yourself and the company.
I’ve been involved with Stella for over two years. Prior to Stella, I was the chief operating officer with Axolotl, an HIE company that was sold to UnitedHealth Group in 2010. Stella Technology is a healthcare IT software company. We’re in interoperability, standards, and care management integration.
What interoperability projects are health systems working on?
A big part of what they’re trying to accomplish is finding ways of building upon their existing infrastructures without having the big expense of doing a rip and replace. A lot of what we’re providing is just that — how to leverage what they already have. Real-time clinical data integration is a big part of it. We’ve been taking all the data that everybody has been collecting and doing something with it, such as analytics and quality measures.
What do you think about ONC’s interoperability roadmap?
We love the roadmap because that’s our sweet spot. When we talk about Stella, we talk about being an HIE and interoperability company that wants to adhere and support and push the standards in the industry. ONC’s roadmap and every single piece they’re doing hits our sweet spot. It’s exactly what we believe in, what they are trying to do. We think the national leadership that’s coming from ONC is going to allow the market to come together.
The standards piece is a big part of it. We need to make use of the existing infrastructure and to build around it. Too many times the easier way is to rip and replace and obviously in this industry you can’t do that. We need to simplify.
Will document-based exchange eventually become obsolete?
Absolutely, and I look forward to that day.
What will interoperability technology look like in a few years?
That’s a loaded question. [laughs] We’ve had a lot of discussions around here. Our chief technology officer, Lin Wan, has been involved with IWG, IHE, and all the standards groups trying to figure out what needs to happen and which path needs to be taken. I’m not quite sure that we know quite yet what’s going to be the path to take. Everybody needs to figure out what national standards are going to be set in order for us to be able to adapt to those standards.
Do the public utility type statewide HIEs and RHIOs have the business models and participation that they need to succeed?
A lot of the work we’re doing with HIEs is trying to help them to make better use of the technology that they already have. HIEs are migrating to something other than what they were born to do. The migration is more to an HEO type structure with quality measures and the reporting that is required by the government. HIEs are going to be successful if they can adapt to these changes.
What common problems do HIEs need help with?
HIEs don’t have a lot of money. They’re all grant funded. They get some money from their participants, but overall, cash is a very big issue for them. We hear them. They need to make use of the investments they’ve already made to set up their infrastructure. We’re trying to help them use the technology that they already have in place by building tools they can start using with what they already have, again, interoperability.
How do you see the connectivity players such as CommonWell, state HIEs, private HIEs, and others fitting together?
There’s going to be a consolidation the marketplace, absolutely. A big chunk of what everybody’s looking at is cost. The HIEs don’t have any money. Hospitals that don’t want to be a part of an HIE will have to set up their own private HEOs and HIEs in order to be able to adapt to the requirements. I think there’s going to be consolidation and it will be driven by cost.
Have you connected to any EHRs via vendor-provided APIs?
We are asking for that. We are finding some cooperation with some of the HIEs, but not all of them. I think it’s going to be a while before that happens, but it needs to happen.
EHR vendors don’t have a lot of incentive or pressure to allow open interoperability. Do you see that changing?
No, I don’t see that changing. What we’re trying to get to is to empower the patient to have more access and more say about their information. The pressure is going to start coming from the patients themselves.
What will your strategy look like over the next five years for interoperability and care coordination?
Our original path at Stella was to be able to address and two things. The first one was care coordination. The second was the patient-centric needs.
On the care coordination part, there’s still a lot that needs to be done. You need to address readmissions. You need to address the patient handoff inside the hospitals. You need to address the continuous communication and contact with the patients. That’s the care coordination piece and we’re doing a good job with that. We have some use cases going on. It’s a piece that has to be addressed and has to be done at an affordable level. Some of the bigger companies have solutions, but they are price prohibitive.
Do you have any final thoughts?
It’s a very exciting time to be in healthcare IT. There’s still a lot of things that need to be done. The migration from public HIEs to private HIEs is allowing companies like Stella to be successful and contribute to the success of what ONC wants to do in their interoperability roadmap. We’re very happy to be part of it.