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State of Technology


Innovation, Entrepreneurship Driving State HIT

Tennessee's gone high-tech, and nowhere is innovation more evident than in the healthcare sector.

In fact, more than 2,300 members now belong to the Tennessee Chapter of the Healthcare Information and Management Systems Society (TN HIMSS), recipient of FY2018 HIMSS Chapter of the Year award as the top large-sized chapter in North America.

Encouraging Entrepreneurship

"The city has changed so much," said Nashville native and Perception Health founder and CEO J. Tod Fetherling. "In the 80's the industry was dominated by HCA and Vanderbilt, and those respective spin-off companies have helped to create the incredible healthcare IT landscape we have today."

Fetherling, who also serves as TN HIMSS's vice president of Workforce Development, said a contributing factor has been the Nashville Entrepreneurial Center, which the Nashville Technology Council helped start under Fetherling's tenures as the organization's president and CEO. "The center has become a front door for entry into our community, and hundreds have been able to scale their business and launch from that effort," he said. "Our ecosystem is getting more and more dynamic."

He also attributes Tennessee's success to its ability to create and attract talent, including efforts of TN HIMSS and Belmont University Health Information Technology (HIT) Workforce Accelerator program. The accelerator provides a new curriculum that helps to propel students toward joining the HIT workforce to support the rapid growth of the industry in Middle Tennessee and is a collaborative engagement between TN HIMSS, Belmont University, Nashville Health Care Council and the Nashville Technology Council. The 14-week program has graduated 200 students, more than half of whom have already been promoted within their organizations. Still, the region maintains 3,500 open positions related to HIT, with a staggering nationwide gap of 50,000 healthcare analysts.

HIT Challenges

Fetherling said interoperability - specifically around a person-centered connective health system - remains top of the list when it comes to HIT challenges in 2019. "When you, as a patient or family member, are forced into the middle of the healthcare system, you realize how ineffective we, as a healthcare community, really are since systems don't typically have all the pieces in one place," he observed.

Fetherling also noted a general disconnect between the ideals of healthcare vs. health insurance vs. health. "We, as a technology community, need to do a better job of defining each term. We intermingle them, but they mean very different things to different people," said Fetherling, a healthcare IT veteran.

His latest effort, Perception Health, has become one of the largest collections of claims data in the U.S. since its 2014 inception. "Five years ago there was an open window for licensing claim data, so we jumped through that quickly before it was closed to other organizations," he explained. "We really wanted to get people focused on care engineering, and we believe today that communities need care engineers to understand where there are gaps in care within communities. Individuals need to know the best places to go and receive care, and that drive to focus on saving lives is at the cornerstone of why we created the company."

Perception Health

Perception's main product is TEAM, a physician referral utilization platform that allows users to see market growth opportunities in a highly visual format. The TEAM platform includes more than 5.5 million clinical entities and more than 900,000 physicians. Perception also is gaining traction around their Care Prediction Tool, which allows users to identify patients at risk of developing complications or disease with 92 percent accuracy in some cases.

"It's fascinating science, technology and math working together to expose new information to the industry," Fetherling said. Care Prediction also allows for customization of the care pathways by looking at the performance of providers and identifying who is best for each patient; Perception recently developed pathways for lung cancer, joint replacement, heart attack and diabetes specifically for CMS.

"We have the largest and freshest data set in the country, updated the first of each month," Fetherling explained. "That gives us the ability to track 280 million patients longitudinally, so we know how they're consuming care and either predict new care they'll need or get them to better providers."

Protecting Your (EHR) Legacy

Antione Agassi

Antoine Agassi, TN HIMSS board member and chairman and CEO of Nashville-based Trinisys, said another challenge facing healthcare organizations is access to electronic health records amid a record setting number of hospital closures. A March 2019 report by Becker's Hospital Review found that Tennessee had the second-most closures since 2010, with 10 hospitals shutting their doors.

"There's not a state that hasn't experienced a number of critical access hospitals closing, and what happens to the those medical records then?" Agassi asked, noting that files legally become property of health departments in most states, with retrieval typically requiring countless hours and phone calls. "When a hospital closes, it creates a big loss to the community as well as a displacement of patients, which creates a big gap in terms of record custody. Besides the loss in continuity of care, missing medical records also mean payers are more likely to pay for redundant medical tests."


Trinisys work with healthcare clients to ensure legacy data archival, particularly amid hospital consolidations and nationwide updates to more advanced EHR systems. The company has partnered with Vanderbilt University Medical Center, which sees more than two million patients annually and recently switched EHR systems when it went live on Epic. Trinisys allowed the medical center to consolidate patient data from numerous legacy systems into an easy-to-use, centralized historic record viewer.

"We ingest multiple sources of data and provide a consolidated dashboard report interoperable with new EHR systems," Agassi explained. "We take disparate data sources of analytical population health and census dashboards and combine them in a shiny new box that's easy to see and understand."



Nashville Entrepreneur Center, Project Healthcare

Perception Health



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Antoine Agassi, Entrepreneur Center, Healthcare IT, Healthcare Technology, HIT, Nashville Health Care Council, Perception Health, Tennessee Healthcare Information and Management Systems Society, TN HIMSS, Tod Fetherling, Trinisys
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