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Promoting Internal Innovation to Drive Healthcare Efficiency

Posted on June 1, 2017 I Written By

The following is a guest blog post by Peyman S. Zand, Partner, Pivot Point Consulting, a Vaco Company.

Technical innovation in healthcare has historically been viewed through the lens of disruption. As tech adoption in the industry matures, perceptions on the origin of innovation are evolving as well. Healthcare leadership teams are increasingly leaning on feedback from the front lines of care delivery to identify ways to eliminate waste and drive greater efficiency. Rather than leaving innovation up to third parties, many health organizations are formalizing programs to advance innovation within their own facilities.

There are two schools of thought on healthcare innovation. Some argue that the market’s unique challenges can only be understood by those in the field, leaving outside influencers destined to fail. Others view innovation success in outside markets as an opportunity for healthcare stakeholders to learn from the wins and losses of more technically progressive industries. By mimicking other industries’ approach to promoting innovation (as opposed to their byproducts) in our hospitals and health systems, healthcare can draw from the best of both worlds. What we know is that the process in which innovation is adopted is very similar in all industries. However, the types of innovations and specific models can and should be tailored to the healthcare industry.

Innovation in Healthcare: Three Examples at a  Glance

There are several examples of health organizations successfully forging a path to institutionalized innovation. University of Pittsburg Medical Center (UPMC), Intermountain Healthcare and Mayo Clinic have pioneered innovation programs that merge internal clinical expertise with technical innovators from vertical markets in and outside healthcare. This article highlights some of the ways these progressive organizations have achieved success.

Innovation at UPMC

UPMC Enterprises boasts a 200-person staff managed by top provider and payer executives at UPMC. The innovation team is presently engaged in more than a dozen commercial partnerships, including support for Vivify Health’s chronic care telehealth solutions, medCPU’s real-time decision support solutions and Health Catalyst’s data warehousing and analytics solutions. Each project is focused on the goal of improving patient outcomes. The innovation group was recently rumored to be partnering with Microsoft on machine learning initiatives and the results may have a profound impact on how we use technology in care delivery.

UPMC Enterprises supports entrepreneurs—both internal individuals and established companies—with capital, technical resources, partner networks, recruiting and marketing assistance to support innovation. Dedicated focus in the following areas lends structure to the innovation program:

  • Translational science
  • Improving outcomes
  • Infrastructure and efficiency
  • Consumer engagement

All profits generated from investments are reinvested to support further research and innovation.

Innovation at Intermountain Healthcare

Like UPMC, Intermountain’s Healthcare Transformation Lab supports innovation in the areas of telehealth and natural language processing (NLP), among others. Like most providers, one of Intermountain’s primary goals is controlling costs. The group’s self-developed NLP program is designed to help identify high-risk patients ahead of catastrophic events using data stored in free-text documents. Telehealth innovations let patients self-triage to the right level of care to incentivize use of the least expensive form of care available. Intermountain’s ProComp solution offers its providers on-the-spot transparency about the cost of instruments, drugs and devices they use. That innovation alone net the health system roughly $80 million in reduced costs between 2013 and 2015.

Most of Intermountain’s innovation initiatives are physician led or co-led. The program strives for small innovations in day-to-day work, supported by a suite of innovation support services and resource centers. Selected innovations from outside startups are supported by the company’s Healthbox Accelerator program involvement, while internal innovations are managed by the Intermountain Foundry. Intermountain offers online innovation idea submissions to promote easy participation. The health organization’s $35 million Innovation Fund supports innovations through formalized investment criteria and trustee governance resources. It is important to note that Intermountain Healthcare is interested in all aspects of innovation including supply chain and other non-clinical related projects.

Innovation at Mayo Clinic

Mayo Clinic’s Center for Innovation (CFI) brings in innovation best practices from both healthcare and non-healthcare backgrounds to drive new ideas. The innovation team’s external advisory council is comprised of both designers and physicians to drive innovation and efficiency in care delivery. The CFI features a Multidisciplinary Design Clinic that invites patients into the innovation process as well.

CFI staff found it was essential to show physicians data that demonstrated known problems and how proposed innovations could make a difference to their patients. They emphasize temporary changes, or “rapid prototyping,” to garner physician buy-in. Mayo’s CFI promotes employee involvement in innovative design through its Culture & Competency of Innovation platform, which features weekly meetings, institution-wide classes, lunch discussion groups and an annual symposium. Mayo’s innovation efforts include these additional physician-led platforms:

  • Mayo Clinic Connection—supporting shared physician experience
  • Prediction and Prevention
  • Wellness—promoting patient education
  • Destination Mayo Clinic—focused on improving patient experience

While these innovation examples represent large healthcare organizations, fostering innovation does not require a big budget. Mayo Clinic’s “think big, start small, move fast” approach to innovation illustrates a common thread among successful innovation programs. Here are practical strategies to advance innovation in healthcare, regardless of organizational size or budget.

Four Steps to Implementing an Innovation Program in Your Organization

Innovation doesn’t have to be grandiose or expensive. Organizations can start small. Begin by opening a companywide dialogue on innovation and launching a simple, online idea submission process to engage personnel in your organization. The most important part of this process is educating your teams to understand how to evaluate new innovations against a relatively pre-defined set of criteria.  For example, are you trying to improve patient safety, quality of care, reduce cost, increase patient or physician satisfaction, etc.

Another key element of successful innovation is encouraging collaboration and participation across a wide variety of stakeholders. Cross-functional teams bring multifaceted perspectives to the problem-solving process. Strive for incremental gains in facilitating opportunities for cross-department collaboration in your organization. This is particularly important for the implementation step.

Measure success using performance metrics where clinical efficiencies are concerned. Physician satisfaction, while difficult to quantify, can also pose big wins. You can expect some failures, but stack the odds by learning from other departments, organizations and industries to avoid making the same mistakes.

To work, innovation must happen often and organically. Dedicate funding, establish cross-department teams and build a formal process for vetting internal ideas. Consider offering staff incentives to drive engagement. Not all ideas will succeed. Identify metrics that will help determine ROI (not all ROIs are measured in dollars) on pilot programs so you can weed out initiatives that aren’t delivering early on to protect resources. Also, keep in mind that you can improve these innovations at each iteration.  Make the process iterative and roll out the initiatives quickly. If it fails, shut the process down quickly and move on. If it is successful, improve it for the next iteration and scale it quickly to maximize the benefits.

Whether you’re cross-pollinating internal teams to promote innovation, building partnerships with other organizations or leveraging technology to better connect providers and patients, healthcare’s ability to successfully collaborate is vital to advancing innovation in healthcare.

About Peyman S. Zand
Peyman S. Zand is a Partner at Pivot Point Consulting, a Vaco company, where he is responsible for strategic services solving healthcare clients’ complex challenges. Currently serving as interim regional CIO for Tenet Healthcare, Zand was previously a member of the University of North Carolina Healthcare System, leading Strategy, Governance, and Program/Project Management. He oversaw major initiatives including system-wide EHR implementation, regulatory programs, and physician practice rollouts. Prior to UNC, Zand formed the Applied Vision Group, a firm dedicated to assisting healthcare organizations with strategic planning, governance, and program and project management for key initiatives.

Zand holds a Bachelor’s of Science in Computational Mathematics and Engineering from Michigan State University, and a Master of Business Administration from the University of Michigan.

ACO-Affiliated Hospitals May Be Ahead On Strategic Health IT Use

Posted on December 26, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the past several years I’ve been struck by how seldom ACOs seem to achieve the objectives they’re built to meet – particularly cost savings and quality improvement goals – even when the organizations involved are pretty sophisticated.

For example, the results generated the Medicare Shared Savings Program and  Pioneer ACO Model have been inconsistent at best, with just 31% of participants getting a savings bonus for 2015, despite the fact that the “Pioneers” were chosen for their savvy and willingness to take on risk.

Some observers suggested this would change as hospitals and ACOs found better health IT solutions, but I’ve always been somewhat skeptical about this. I’m not a fan of the results we got when capitation was the rage, and to me current models have always looked like tarted-up capitation, the fundamental flaws of which can’t be fixed by technology.

All that being said, a new journal article suggests that I may be wrong about the hopelessness of trying to engineer a workable value-based solution with health IT. The study, which was published in the American Journal of Managed Care, has concluded that if nothing else, ACO incentives are pushing hospitals to make more strategic HIT investments than they may have before.

To conduct the study, which compared health IT adoption in hospitals participating in ACOs with hospitals that weren’t ACO-affiliated, the authors gathered data from 2013 and 2014 surveys by the American Hospital Association. They focused on hospitals’ adherence to Stage 1 and Stage 2 Meaningful Use criteria, patient engagement-oriented health IT use and HIE participation.

When they compared 393 ACO hospitals and 810 non-ACO hospitals, the researchers found that a larger percentage of ACO hospitals were capable of meeting MU Stage 1 and Stage 2. They also noted that nearly 40% of ACO hospitals had patient engagement tech in place, as compared with 15.2% of non-ACO hospitals. Meanwhile, 49% of ACO hospitals were involved with HIEs, compared with 30.1% of non-ACO hospitals.

Bottom line, the authors concluded that ACO-based incentives are proving to be more effective than Meaningful Use at getting hospitals adopt new and arguably more effective technologies. Fancy that! (Finding and implementing those solutions is still a huge challenge for ACOs, but that’s a story for another day.)

Of course, the authors seem to take it as a given that patient engagement tech and HIEs are strategic for more or less any hospital, an assumption they don’t do much to justify. Also, they don’t address how hospitals in and out of ACOs are pursuing population health or big data strategies, which seems like a big omission. This weakens their argument somewhat in my view. But the data is worth a look nonetheless.

I’m quite happy to see some evidence that ACO models can push hospitals to make good health IT investment decisions. After all, it’d be a bummer if hospitals had spent all of that time and money building them out for nothing.

Is IT The Reason CEO Turnover Is So High?

Posted on March 11, 2014 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study from the American College of Healthcare Executives reports that hospital CEO turnover increased to 20 percent in 2013, the highest rate reported since ACHE began tracking these numbers in 1981.

There are several reasons one could identify as causes for high CEO turnover, including the retirement of baby boomers and the trend towards consolidation in the industry, which may eliminate jobs.

All that being said, I believe that the most likely reason for high CEO turnover of late is the turmoil around IT, including but not limited to evaluating and buying equipment from EMR vendors, managing process changes as the EMR is installed, seeing to it that the EMR doesn’t bankrupt the hospital and more.

And then, there is a need for management to be responsible for all of the systems that feed into the EMR, and to do something with the data that they produce.

Bottom line, it’s hardly surprising that there are a record number of CEOs struggling to stay on top of the crest where IT is concerned.  And it’s also not too surprising that some CEOs, who had done very well as the responsible leader with their hands on the wheel, might be less suited to the massive changes that can occur in the wake of IT transformation.

No, in reality it’s not very surprising that this is a time of high turnover for CEOs.  When you pile on the various revolutions taking place in healthcare IT, and the need to lead your staff through them, manage them and prepare for the future, you have what might be seen as an impossible job for some CEOs. It’s not a big surprise that particularly high number of hospital CEOs are calling it a day — or having it called for them.

The Promise Of Medicaid Health Home Technology

Posted on June 6, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest post by Ms. Lori Evans Bernstein, President of GSI Health.

The Affordable Care Act of 2010 introduced the health care industry to Medicaid Health Homes, an optional Medicaid State Plan benefit program designed to improve Medicaid care coordination and delivery for patients with two or more chronic conditions. Of course, like so many aspects of the new legislation, this provision created at least as many questions as it has answered. Most importantly, what kind of technology will Medicaid Health Homes require to ensure successful implementation?

In order to answer that question, you need look no further than the primary benefits this new care model offers:

Collaboration
Medicaid Health Homes are expected to offer “whole-person” care. That means breaking down the silos that have traditionally separated care providers into categories such as medical, social and behavioral and inpatient, outpatient and post-acute. This is no easy task.

Medicaid Health Home technology needs to offer care providers the tools and resources required to bridge the information and collaboration gap those traditional care silos have created. Individual care providers require a flexible solution to share patient information and collaborate on their care effectively and efficiently among multiple providers and across the care continuum.

In short, Medicaid Health Homes and Accountable Care Organizations (ACOs) need a health IT platform capable of unifying not only data from different sources but also providers in different settings and distributing relevant patient information in a precision-targeted manner.

Accountability
Delivering on the promise of “whole-person” care is not just about connecting systems. It’s about connecting people and creating a clear path to accountability. Medicaid Health Home technology needs to connect patients with the integrated network of care providers required to address their unique individual needs. In order to achieve that mission, care providers require a health IT solution that goes beyond today’s electronic health record systems used “inside the four walls” capable of connecting them seamlessly with the colleagues and fellow professionals required to establish a complete picture of each patient’s care history.

With so many different professions and providers collaborating on patient care, creating a comprehensive workflow is essential if Medicaid Health Homes are to be successful. Analyzing data and reporting outcomes and predicting risk and events are necessary, but not sufficient to improve outcomes and reduce costs.  The tools enabling collaboration on patient care that, for example, alert the provider to an ED admission, manage referrals to various providers and community services, reconcile medications during a transition of care, engage patients in their care and provide a dynamic coordinate care plan are essential to building and succeeding along the path to accountability among various providers and with patients. In order to oversee the implementation of those collaboration tools and provide accountability, you need Medicaid Health Home technology that connects your care team quickly and dynamically to act on patient events, care processes and new information.

Payment
One of the most important and pressing questions Medicaid Health Homes raise is how best to handle payment under this new care model. Currently, many ACOs and Medicaid Health Homes are trying to retrofit old payment models to the new paradigm or manage the old and new paradigms simultaneously. This approach isn’t working because, given the diversity of providers (medical, behavioral, social), it is dramatically less efficient and effective to bill incrementally and too complex to manage multiple payment models.

Instead, these organizations need to start viewing their billing coordination efforts along a continuum and from a more whole person care perspective. In the future, payers will have to figure out a new approach to allocation and distribution between different organizations. In order for this new model to be successful, ACOs and Health Homes need the health IT tools and platforms capable of unifying their reporting, allocating payments and providing administrative tracking capabilities.

As new Medicaid Health Home payment models evolve, Medicaid Health Home technology needs to create the sorts of integrated financial tools that allow a diverse group of providers and payers to create a truly cohesive care experience for every patient.

So what does all this mean for ACOs and other networks or organizations currently weighing the benefits of establishing a Medicaid Health Home? While there are plenty of important questions to be asked on a case-by-case basis, one answer is clear: In order to deliver the increased quality of care and potential cost-saving benefits, it pays to invest in the kind of Medicaid Health Home technology that takes the key criteria above into account.

GSI Health recently authored a free downloadable whitepaper for healthcare organizations considering forming a Medicaid Health Home titled, How To Turn The Promise Of Medicaid Health Homes Into Reality. To download it and learn more about GSI Health’s momentum with Medicaid Health Homes, visit medicaidhealthhomes.gsihealth.com

Ms. Lori Evans Bernstein is the President of GSI Health, a health IT provider. Ms. Evans Bernstein has over two decades of experience in healthcare, including: executive roles within health care and health IT corporations; senior federal and state governmental appointments; health care delivery system operations; and health services and policy research. She writes and speaks regularly on health IT across the country and participates in numerous industry and federal and state policy initiatives as a national expert. Follow GSI Health and Ms. Evans Bernstein on Facebook, Twitter and Google+.  

Guest Post: How Can Health IT Help with Hospital Customer Service

Posted on August 24, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest post by Ron Troy. Ron Troy is a MBA, IT professional, and someone who has spent far too much time in hospitals for not actually working in them (since his teens)!

One of the topics in the ONC based HealthIT training I’m currently going through is Customer Service.

It’s arguable that customer service in a hospital setting is a bad joke with some exceptions. Hospitals are all about processing as many patients as possible with as little in the way of resources as possible to keep down costs while maximizing revenues. Patients don’t so much pick a hospital as an emergency or a doctor picks one for them, and hospital management and staff know that.

Consider the ER experience from a patient view point. Assuming you didn’t come by ambulance and are not having a heart attack or profusely bleeding, a triage nurse takes some info and tells you to sit – if you can find one of the worn out uncomfortable seats. I did this once for several hours with a hot, painful appendix! Eventually someone calls you over for your insurance info, and you then go back to find your seat gone. So, you are in pain, uncomfortable, maybe bleeding (but not too bad); eventually you will get called in and put on a hard as rock stretcher – probably on the side of a narrow hallway. Within just a few hours someone will take your vitals, a doctor will eventually show up, some tests will be done, and you finally get some treatment or told you will someday be admitted or taken to the OR. You are now desperately thirsty, hungry, and in more pain! And that’s just the ER!

Upstairs, rooms are noisy with alarms (EKG, IV pumps, etc.) that only patients seem to hear. You finally fall asleep only to be woken up for a sleeping pill or to get your BP taken. For the first few days you get food chosen by someone else – never what you want, you get your first menu to fill out when you are about to be discharged. Once in a while a doctor comes in to say hello, and later you discover you owe the guy hundreds for that hello!

I could go on, but this is hardly ‘customer service’. Or by the definition of a HealthIT lecture, a good example of poor service. You may get excellent health care, maybe your IV’s that are supposed to be continuous are not allowed to run out and maybe they don’t keep stopping, but you have only lousy memories of the experience.

Many years ago, I worked for a while as Assistant Director of Housekeeping at Doctor’s Hospital in Manhattan (now part of another hospital). You walk in the main lobby and you think you are in a luxury hotel. It is very quiet and calm – one could refinish the floor there mid day and not cause a problem (but you would never do so). The floors themselves are also very calm and quiet. The basic food is good, but you can order actual room service quality food (complete with tux clad waiter) if you want. Patient care is very good, and when you want to sleep at night, odds are you will be in a quiet room in a good hospital bed. You won’t pick up any new bug – the place is way too clean for that.

I don’t expect all that in today’s hospitals, but they could sure learn something about how patients get better faster when calm and quiet and comfortable and decently fed! HealthIT can assist in that – especially when hospital IT gear is inter connected. EKG monitors, IV pumps, blood oxygen sensors and the like popping up flags on the nursing station big monitors and nurses’ pads or laptops instead of alarms shrieking all over the place. A new patient arrives, gets handed a pad (if they are up to it) to note meal preferences, desire for TV and phone. It can even take their credit cards to pay for the extras. Better yet, a touch screen TV / terminal at each bed- press the ‘call nurse’ button and someone pops up on screen (and they can see you and talk to you) and you tell them in a low, plain voice what’s wrong. Then the right person can come to help. And if you really want to push the envelope, that screen can have a button to press that will show you what tests, doctors visits and more you are scheduled for, and about when! Nice – you can tell prospective visitors what your EXPECTED schedule is! And you might even let your patient see a view of test results (and when the doctor will be available to discuss them).

The point being; customer service in hospitals can be good, and can even make the hospital more cost effective! It can even help the patient to be part of the healing process. And HealthIT can be a part of that – though a customer service attitude would really help too!

Notable Women in Health IT

Posted on March 22, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Too often, I’m forced to use the pronoun “he” when discussing the luminaries of health IT.  Certainly, that’s partly because health IT is a boy-geek world, but we mustn’t forget the female powerhouses in the biz.

For example, here’s some samples from a list of 12 HIT women you should know, courtesy of www.hitconsultant.net.

  • Judith Faulkner:  Love her or hate her (and experienced readers know where I stand!) Faulkner is perhaps the most powerful woman in health IT — maybe in health IT period!   Between 1979 and today, she’s built a company which stands like a Colossus astride hospital IT, and you’ve gotta admit, that’s one hell of an accomplishment.
  •  Halle Tecco:  Tecco is co-founder of Rock  Health, a seed-stage business accelerator focused on health startups. As if the buzz factor alone wasn’t enough to earn her a spot — Rock Health is cooler than Elvis these days — she’s managed to draw funding from Microsoft, Qualcomm, Quest Diagnostics and Genentech, a quatra-fecta cutting across enterprise IT, wireless, clinical reference labs and biotech.
  • Tiffany Crenshaw:  Crenshaw, president and CEO of health IT recruiting firm Intellect Resources, is not just any smile and dial recruiter.  She created a new event called Big Break, a one-day audition process allowing hospitals to hire a 200+ person training and go-live team in just one day. Now that’s a turnaround.

To catch the other nine, which include everyone’s favorite HHS chief Kathleen Sebelius, visit the site here.

By the way, if I had made the list, I would have included any of the female senior leaders from big, bad health information network Availity;  Mary Pat Whaley, leader of Manage My Practice; and just about any of the CIOs  or CNIOs of five+ hospital IDNs. It’s categories like these where I expect to see real growth, especially the CNIO/VP of nursing informatics slot.

What do you think?

Hottest Job Skills For Health IT Pros This Year

Posted on January 9, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s a nice little take on how the health IT recruiting market is shaping up for this year.

According to recruiter Guillermo Moreno, vice president of recruiting firm Experis Healthcare, not only will IT leaders be fighting for team members with EMR/EHR skills, there’s also five other health IT skillsets that will be in high demand:

* ICD-10/5010 expertise:   With companies migrating to ICD-10, demand for informed pros will be  at an “all time high” in 2012, Moreno notes. (Editor’s note: If you haven’t hired them already, or at least begun reaching out, you’re really, really late to the game. Surely you’re better prepared, readers?)

* Applications insights:  Moreno notes that healthcare organizations need strong developers to create apps focused on measuring quality and meeting standards. Hard to argue that.

* Security and compliance chops:  This year, providers are moving from focusing largely on internal security to making sure information moves safely from one location to another, Moreno says. So pros with a strong grasp of information security management will be hotly pursued this year.

*  Data management abilities:  As Moreno sees it, there’s still some data management and data security skillsets that aren’t too common in healthcare.  In the near future, he says, such experts will be badly needed, in part to make sure organizations have plans in place to prepare for possible losses of protected information.

* BI/analytics experience:  If providers hope to aggregate data in a sophisticated way — something that will be more needed each year as quality measurement standards spike — they’ll need to recruit more pros with business intelligence and analytics skills.  That’s particularly the case now, given that current packaged healthcare analytics tools aren’t that mature, Moreno argues.

I find it hard to argue that these are all hot areas for health IT recruiting. There’s a couple others I think should be hot recruiting items too:

* CMIO/CNIO etc.:  If hospitals are smart, they’ll do more to recruit crossover medical/IT pros who can speak to both sides and make clinicians comfortable with new tech. Putting volunteer “champions” in place can’t do much if the technology wasn’t a good clinical fit in the first place.

* Health IT project managers:   With health IT departments swamped with  big picture demands, simply getting the day to day project work done is no joke. Sure, hospitals may have big-ticket consulting firms in place to handle the checkbox work right now, but when those folks pack up, will your IT organization have enough smart project  managers in place be able to keep the trains running on time?

I’d argue that there’s also room to create as-yet unknown jobs which are more or less pure EMR cheerleader, user experience researchers and vendor harassment liasons. (OK, the last one is a bit over the top…but I stand by the other two. And while we’re at it, is there anyone whose day-to-day job it is to hold vendors’ feet the fire?)

 

Free Broadband Internet Could Change Dramatically Shift Health IT Strategy

Posted on December 12, 2011 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Today, I read that a new venture expects to offer free broadband Internet connections to all Americans sometime in mid-2012, starting in areas where existing commercial access is spotty and moving outward from there.  Before your “bulls***t” alarm goes off, it’s worth noting that the new venture, FreedomPop, is backed by Skype co-founder Niklas Zennstrom — a guy who at least deserves a hearing when it comes to technical innovation.

(Now, the scuttlebutt is that FreedomPop isn’t going anywhere until it figures out how to stop screwing up GPS signals, but even if it does face a problem of that magnitude, my guess is that with enough money, enough JoltCola and enough programmers at foosball tables, FreedomPop will fix things somehow.)

But, you say, why does this matter to me, a hospital IT master of the universe who’s much too busy to reach Engadget and purr over cool technological launches?  Well, here goes. My theory is that whether FreedomPop or a competitor pulls it off, we’re on the verge of free broadband Internet either way, probably within 24 months at most.  And once that happens, the nature of the way providers and consumers share medical information is going to change dramatically. So brace yourself for a new world in which bandwidth bottlenecks simply aren’t the issue driving everything else you do.

I admit that even if free broadband Internet connections were available across the U.S. right now, it might not have an immediate effect on how EMRs and other forms of health data sharing evolve.  But once such services are available to all, make no mistake — your job is going to change dramatically. Think I’m exaggerating?

Here’s just a few of the ways health data management will explode when broadband access is everywhere.  I’d love to know whether you think I’m getting ahead of myself here. To me, we’re barely in time to prepare!

-Katherine

Ways Free Broadband Internet Will Change Health IT 

*  Videoconferencing will become trivial, and patients, by sheer force of demand, will push doctors into delivering high volumes of consults via video.  Storing, indexing, reusing, broadcasting and manipulating such files will become a core part of your job.  Sound beastly? You bet it is, but there’s no way around it.

* Patients will expect low-latency access to their charts, educational video, the live feed from the cameras tracking their new-born niece, high-res images of the x-ray showing their broken wrist and so on.

* Doctors will expect you to support a brand new set of video, audio and data services which would never have worked in the narrowband world, everything from virtual medical conferences on Second Life to world-wide video Webinars.

*The volume of data your institution sends, receives and stores will shoot up astronomically. While you may end up dumping a lot of the excess, duplicative items, you’ll have to develop new storage and disaster recovery strategies to deal with that you do keep.

*Existing forms of Internet traffic will take on new significance. With everyone signed on, lots of serious talk will go on online. While IM chat might once have been just that, chat, now it very well may be IM+video+audio chat wich should be appended to a patient’s chart and eventually shared across an HIE.

*  The cloud (in whatever form it evolves to be) will be unavoidable. That means new ways of measuring, monitoring, securing, sharing and storing healthcare data.

Industry Does Too Little, Too Late On HIT-Related Safety Issues

Posted on November 11, 2011 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

This week, a pair of HIT organizations — including a HIMSS-backed group and an alliance focused on HIT safety — came together to help track HIT-related patient safety problems. The two groups have broad-based vendor support, and they seem to have the right goals. Unfortunately for them, though, the HIT safety ship may have already sailed.

Participants in the current linkup include the iHealth Alliance, part of the  EHR safety group EHRevent.com run by the publishers of the Physicians’ Desk Reference, and the HIMSS EHR Association, a collection of 44 EHR vendors working together to work on key industry issues.

The safety group, which offers a quick form allowing people to report EHR-related safety concerns, is an official, federally-certified Patient Safety Organization. That gives providers the chance to report such events in a privileged, confidential manner.

That being said, regulators seem to have gotten the jump on the software folks. As some of you may know, regulators are already preparing to begin, well, regulating HIT safety results. The FDA, which issued draft guidance on mobile medical apps this summer, may cast its eye on EHRs at some point.

Another possible angle comes from the Institute of Medicine, which recently issued a report recommending that HHS create a new watchdog agency investigating health IT safety issues.  National Coordinator for Health IT Farzad Mostashari recently told reporters that his agency, the ONC, has already begun developing an EHR safety and surveillance plan which should be out within the next 12 months.

(If you want this process to be as painless as possible, you’d better hope that the IOM gets its way; vendors, you don’t want to face the kind of FDA struggles pharmaceutical companies do, right?)

Honestly, someone who’s watched regulators do their thing for decades, I’m betting this latest industry effort will be too little, too late.

Folks, as I see it the only way you’ll get the agencies off your back is to start reporting on safety issues with EMRs/EHRs and other health IT tools aggressively. But given that many organizations aren’t even at the stage where their EMR installation is stable, good luck!

Small HIT Grant May Make Big Difference For Rural Hospitals

Posted on September 12, 2011 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Really, what can you do with a $12 million dollars IT budget? Perhaps it could launch one solid EMR at a mid-sized hospital, but it’s not likely to stretch much beyond that in suburbia.

Fortunately, the economics of IT are different in the hinterland. It looks like the $12 million HHS plans to dole out to rural hospitals may have a real impact on their efforts to adopt EMRs and meet Stage 1 Meaningful Use requirements.

Under the HHS program, which was developed as part of the president’s Rural Health Initiative, about 40 organizations will get about $300,000 each in health IT funding. The grants will help rural hospitals to buy technology, install broadband networks and pay for training.

The Obama administration is also offering loans to more than 1,300 rural, critical access hospitals to buy health IT, notably systems designed to raise the quality of care, according to Information Week.

OK, now you’re going to see my prejudices on display. So here goes.

Everything I read and see suggests that rural hospitals can make great use of EMRs and other forms of high-level health IT. So, if it were up to me, the feds would spend far more helping critical access hospitals get up to speed than paying off community hospitals to do what they have to do anyway.

Not only does health IT help rural systematize care, it also lays the foundation for creating effective HIEs.

And in my book, rural facilities need help with HIEs far more than suburban hospitals. After all, if anything, rural hospitals operate on even slimmer margins than their urban/suburban peers.

I’d like to see more projects like this one, in which two rural hospitals got together to share the costs of their Meditech EMR launch. But that kind of partnership is something that won’t happen every day, as such a match requires a unique level of compatibility.

If they invest in rural hospitals, though, the feds could do much to foster such partnerships. I hope to see them do so!