I am now a member of the blog team at Healthcare Informatics.
Please visit my blogs where I will share insights surrounding technology evaluation, selection, adoption, transparency and governance.
Visit http://www.healthcare-informatics.com/michael_craige
Monday, September 08, 2008
Munchausen Syndrome at Work - Managers Be Aware!
How to identify problem employees in the workplace - the Munchausen Syndrome!
http://abcnews.go.com/Video/playerIndex?id=5706197
The new workplace phenomenon and danger! These problem solver are more danger than good to your organization. Every office one insecure employee who creates problems or seeks to identify other co-workers to blame or to show them breaking company policies.
These employees are insecure and always seeking attention. Creating problems just to be the hero - who solves the problems but end up hurting the organization and fellow employees.
The problems is most managers are not aware of this problem and ends up rewarding and/or promoting these employees.
Please play this link - it comes after the commercial.
http://abcnews.go.com/Video/playerIndex?id=5706197
http://abcnews.go.com/Video/playerIndex?id=5706197
The new workplace phenomenon and danger! These problem solver are more danger than good to your organization. Every office one insecure employee who creates problems or seeks to identify other co-workers to blame or to show them breaking company policies.
These employees are insecure and always seeking attention. Creating problems just to be the hero - who solves the problems but end up hurting the organization and fellow employees.
The problems is most managers are not aware of this problem and ends up rewarding and/or promoting these employees.
Please play this link - it comes after the commercial.
http://abcnews.go.com/Video/playerIndex?id=5706197
Tuesday, August 19, 2008
This Is No Brain Surgery - Know Your Audience
This is not brain surgery, but it does require a thoughtful view of the situation.
Yesterday I was reminded by our senior administrative staff member, that I should always get to know my audience and the individuals I meet. What did she meant? Say you've been invited to a meeting, dinner or reception and Paul Levy (President and CEO of Beth Israel), Barack Obama and Tom Peters will be there. Don't forget to do your homework!
You'd better Google them all. And make sure you know where they went to school, what their accomplishments are, and be prepared to discuss Paul's turn-around of Beth Israel Deaconess Medical Center, and how he took over a troubled organization, in serious financial difficulty. Why? Because you are more likely to "get connected" to these folks and that connection can make all the difference in the world. Just takes a few minutes and it will pay off handsomely.
Tip: Do it for every person and event you attend. And they don't have to be Obama (superstars) to be Googleable (is that a word?).
Yesterday I was reminded by our senior administrative staff member, that I should always get to know my audience and the individuals I meet. What did she meant? Say you've been invited to a meeting, dinner or reception and Paul Levy (President and CEO of Beth Israel), Barack Obama and Tom Peters will be there. Don't forget to do your homework!
You'd better Google them all. And make sure you know where they went to school, what their accomplishments are, and be prepared to discuss Paul's turn-around of Beth Israel Deaconess Medical Center, and how he took over a troubled organization, in serious financial difficulty. Why? Because you are more likely to "get connected" to these folks and that connection can make all the difference in the world. Just takes a few minutes and it will pay off handsomely.
Tip: Do it for every person and event you attend. And they don't have to be Obama (superstars) to be Googleable (is that a word?).
Monday, August 18, 2008
Healthcare IT and EMR Infrastructure - Going Green Strategies
As an Information Technology (IT) professional I spend most of my working days interacting with Data Centers in some way or the other. Today more that before I noticed that most IT Data Centers are at their max with space constraints, power/heat constraints, and aging technology infrastructure. Over time, like most technology, hospital and business buildings has become old and less suitable with many energy related challenges. Challenges that are now attracting the EPA.
At the end of 2006 the EPA was asked to present a report about the large amount of energy which is now being spent in the United States on IT data centers. The report was provided to the US Congress on August 7th of 2007.
Today newly build medical buildings are moving in the direction of earth-friendly construction. But these changes are more about energy conservation, they are more environmental related and much to help patients recover quicker. From a physician perspective - new environmental and energy efficient buildings are about reducing medical errors.
On the IT side, one of the the first step of data centre consolidation is to reduce the number of physical data centers to operate and to be able to manage a simplified environment.
Secondly, move on the physical consolidation of servers and storage which will give way to virtualization.
Virtualization strategy focuses on the removal of physical resource boundaries and ultimately increases hardware utilization (allocate less physical boundary and reduce software licensing costs). This will allow you to better utilize your equipment. As you virtualize machine from both a server and storage standpoint you will be able to leverage your distributed space and have low utilization which will reduce the amount of equipment in the data center. And as you reduce the amount of IT equipment in your data center as a results, the amount of power and cooling that the data centre requires drops drastically.
Secondly - application integration. The secret behind virtualizing your application is to consolidate the images of your software/OS onto a single physical server and by doing so reduce the number of copies for your operating system and of the middle ware applications (databases or web) by merging those application within one distributed database image or web image. This will overall reduce your software and licensing cost.
Finally, on the facility side, try to follow a strategy that's supported by the EPA and other environment friendly recommendations. You will improve your operations through conservation techniques. From a best practice perspective, approach your IT data center and equipment by looking at the efficiency of those individual resources and leveraging them. Also take into consideration your geographic location and how to leverage other capabilities such as free cooling.
As an IT Manager or CIO, there are a large number of virtualization techniques in the industry today for consideration and best fit for your infrastructure (Windows, Mac OS, UNIX or Linux). The large amount of electrical power being spent on IT today have reached the point where it has attracted both government and environmental attention and the projection for additional Health care IT applications will only exacerbate the situation if current technology trends continue unchanged. A number of IT Equipment manufacturers are addressing the situation at the server end through integrated IT/facilities modular solutions, but virtualization so far is the most promising technology to address both the issues of IT resource utilization and facilities space, power, and cooling utilization.
At the end of 2006 the EPA was asked to present a report about the large amount of energy which is now being spent in the United States on IT data centers. The report was provided to the US Congress on August 7th of 2007.
Today newly build medical buildings are moving in the direction of earth-friendly construction. But these changes are more about energy conservation, they are more environmental related and much to help patients recover quicker. From a physician perspective - new environmental and energy efficient buildings are about reducing medical errors.
On the IT side, one of the the first step of data centre consolidation is to reduce the number of physical data centers to operate and to be able to manage a simplified environment.
Secondly, move on the physical consolidation of servers and storage which will give way to virtualization.
Virtualization strategy focuses on the removal of physical resource boundaries and ultimately increases hardware utilization (allocate less physical boundary and reduce software licensing costs). This will allow you to better utilize your equipment. As you virtualize machine from both a server and storage standpoint you will be able to leverage your distributed space and have low utilization which will reduce the amount of equipment in the data center. And as you reduce the amount of IT equipment in your data center as a results, the amount of power and cooling that the data centre requires drops drastically.
Secondly - application integration. The secret behind virtualizing your application is to consolidate the images of your software/OS onto a single physical server and by doing so reduce the number of copies for your operating system and of the middle ware applications (databases or web) by merging those application within one distributed database image or web image. This will overall reduce your software and licensing cost.
Finally, on the facility side, try to follow a strategy that's supported by the EPA and other environment friendly recommendations. You will improve your operations through conservation techniques. From a best practice perspective, approach your IT data center and equipment by looking at the efficiency of those individual resources and leveraging them. Also take into consideration your geographic location and how to leverage other capabilities such as free cooling.
As an IT Manager or CIO, there are a large number of virtualization techniques in the industry today for consideration and best fit for your infrastructure (Windows, Mac OS, UNIX or Linux). The large amount of electrical power being spent on IT today have reached the point where it has attracted both government and environmental attention and the projection for additional Health care IT applications will only exacerbate the situation if current technology trends continue unchanged. A number of IT Equipment manufacturers are addressing the situation at the server end through integrated IT/facilities modular solutions, but virtualization so far is the most promising technology to address both the issues of IT resource utilization and facilities space, power, and cooling utilization.
Sunday, August 17, 2008
Note to Readers
The business of Healthcare IT (infrastructure, applications, management, governance, bio-informatics and just any technology) is what I love to do and I must say its becoming very important and vital to our health system. I receive many comments on this blog each day; however not all are posted.
My hope is that much will be learned from the sharing of useful information and personal experiences (not just mine) based on the technology, medical and health topics shared daily. I encourage you to focus your comments on those healthcare and technology topics and I appreciate your input. Thank you for your participation.
My hope is that much will be learned from the sharing of useful information and personal experiences (not just mine) based on the technology, medical and health topics shared daily. I encourage you to focus your comments on those healthcare and technology topics and I appreciate your input. Thank you for your participation.
Saturday, August 16, 2008
Ride to Work - Save Some Gas (Money)
I rode my bike (2007 MV Agusta F4-1000R) to work yesterday (Friday) with the intention to save on gas and end up burning some calories at the same time. 87 degrees in Atlanta, GA is no joke - its hot when riding!
Cheap gas seems to be a memory of the past as we all look to save money on fuel - savings is never all that fun.
Well, I did both yesterday save money and gas. I saved on (gas) money and had fun at the same time, on my motorcycle! I must say motorcycles are some of the best vehicles to give you the best economy, efficiency and gas mileage.
Cheap gas seems to be a memory of the past as we all look to save money on fuel - savings is never all that fun.
Well, I did both yesterday save money and gas. I saved on (gas) money and had fun at the same time, on my motorcycle! I must say motorcycles are some of the best vehicles to give you the best economy, efficiency and gas mileage.
Have fun and a safe ride!
Friday, August 15, 2008
Disaster Recovery Strategies
****Have a Plan of Attack, Not a Panic Attack****
Disaster recovery is traditionally defined as the ability to recover from a catastrophic outage of a health care IT infrastructure, clinical equipment, business systems and health services. Protecting and maintaining clinical data, equipment and processes should be the primary goal of your "Disaster Recovery Strategies".
What would you do if disaster struck your hospitals and/or clinics? When I say disaster, I meant, any (earthquake, flood, blizzard, etc.), prolonged power outages, virus or hacker attacks, crime/terrorism, software failures, hardware failures and human error (one of my favorite).
I can testify how expensive unplanned data and systems loss can be. On average companies spend over $11 billion a year to recover lost data and I would not be surprise to learn that the value of your clinical data today is some where around at $1 million/100 MB. [A complete IT outage costs the average business around $84,000 an hour (IDC)]. Its also important for you to know that 90%of most companies that suffer catastrophic data loss without a disaster recovery plan close within 18 months - (PricewaterhouseCoopers study cited by the SANS Institute, August 2001).
Disaster recovery is traditionally defined as the ability to recover from a catastrophic outage of a health care IT infrastructure, clinical equipment, business systems and health services. Protecting and maintaining clinical data, equipment and processes should be the primary goal of your "Disaster Recovery Strategies".
What would you do if disaster struck your hospitals and/or clinics? When I say disaster, I meant, any (earthquake, flood, blizzard, etc.), prolonged power outages, virus or hacker attacks, crime/terrorism, software failures, hardware failures and human error (one of my favorite).
I can testify how expensive unplanned data and systems loss can be. On average companies spend over $11 billion a year to recover lost data and I would not be surprise to learn that the value of your clinical data today is some where around at $1 million/100 MB. [A complete IT outage costs the average business around $84,000 an hour (IDC)]. Its also important for you to know that 90%of most companies that suffer catastrophic data loss without a disaster recovery plan close within 18 months - (PricewaterhouseCoopers study cited by the SANS Institute, August 2001).
So where am I going with this? Who in your organization sole job is focus only "Disaster Recovery and Risk Management". A successful disaster recovery and risk management plan will rely on (1) senior management’s commitment; (2) the full support and participation of your CIO and his/her health care IT team; (3) Your DR/RM assessment team, must have the expertise to apply the risk assessment methodology developed and to provide cost-effective safeguards that meet the needs of your organization; (4) the promotion of awareness and cooperation of your entire user community, and (5) an ongoing evaluation and assessment of the the plan.
Well, I hope this shed some light. Next I will touch on "Business Continuance" which is not the same as "Disaster Recovery" - a totally different but very important animal.
EMR - Is It Too Expensive For You?
I recently read a book entitled "An EMR Journey" by Rod Tanchanco M.D. (Internal Medicine of Delaware, LLC), and would like to encourage you to get a copy today if you are considering purchasing an EMR system or simply just need advise for your practice.
Dr. Rod Tanchanco....."When I decided to go solo and opened my Internal Medicine practice in Middletown, Delaware, it was a given that as I was starting from scratch, I would have to go paperless. It was certainly not an easy road, even with all the guides and preparations that I tried to avail of and utilize. And there are a lot of resources, albeit often too technical for my taste, that a physician can turn to for guidance and help. I am writing this book to offer my own experience with EMR implementation, and describe the steps that I took."
Here's a list of useful EMR resources regarding EMR implementation and quality measures.
The following is a link to useful information regarding EMR, Return on Investment:http://www.emrexperts.com/emr-roi/index.php
American College of Physicians (http://www.acponline.org/pmc/ehr.htm)
This is the ACP’s practice management center’s page on EMRs containing useful documents and guides. Some areas may be for members only.
AAFP Center For Health Information Technology (http://www.centerforhit.org/)
For members of AAFP, the ChiT webpage is an excellent place to start as it outlines the complete process of adopting EMRs.
EMR Consultant (http://www.emrconsultant.com/)
A useful site for vendor comparison, forums and blogs on EMR, and an online ‘matching’ program which matches a practice’s needs to EMR solutions.
Healthcare Informatics
(http://www.healthcare-informatics.com/)
This periodical is a great reference for a listing of EMR vendors, the products they offer, as well as their features. Click on "Resource" on the left panel, then choose "EHR" from the list.
Medicare Quality Improvement Community (http://www.medqic.org/) A rather technical and exhaustive resource which is geared more for Quality Improvement Organizations.
The AC Group (http://www.acgroup.org/) AC Group is one of the leading companies, specializing in the evaluation, selection, and ranking of vendors in the PMS/EMR/EHR
healthcare marketplace.
Klas (http://www.healthcomputing.com/) KLAS is a research and consulting firm specializing in
monitoring and reporting the performance of Healthcare's Information Technology (HIT) vendors.
Quality Net (http://www.qualitynet.org/) Established by the Centers for Medicare & Medicaid Services (CMS), QualityNet provides healthcare quality improvement news, resources and data reporting tools and applications used by healthcare providers and others.
DOQ-IT (http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2114&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=false&cboOrder=date) Doctors’ Office Quality – Information Technology. The QIO community is a national network of 53 organizations working under a contract with the Centers for Medicare & Medicaid Services to educate and assist physician offices with EHR system selection and implementation.
Ambulatory Care Quality Alliance (http://www.ambulatoryqualityalliance.org/default.htm)
A coalition of the American Academy of Family Physicians (AAFP), American College of Physicians (ACP), America’s Health Insurance Plans (AHIP), and Agency for Healthcare Research and Quality AHRQ whose mission is to determine how to most effectively and efficiently improve performance measurement, data aggregation, and reporting in the ambulatory care setting.
Centers for Medicare & Medicaid Services (http://www.cms.hhs.gov/pvrp/)
Link to the CMS’s Physician Voluntary Reporting Program.
National Committee on Quality Assurance (http://www.ncqa.org/)
Contains information on the various Physician Recognition Programs.
I hope this information is useful to you.
Dr. Rod Tanchanco....."When I decided to go solo and opened my Internal Medicine practice in Middletown, Delaware, it was a given that as I was starting from scratch, I would have to go paperless. It was certainly not an easy road, even with all the guides and preparations that I tried to avail of and utilize. And there are a lot of resources, albeit often too technical for my taste, that a physician can turn to for guidance and help. I am writing this book to offer my own experience with EMR implementation, and describe the steps that I took."
Here's a list of useful EMR resources regarding EMR implementation and quality measures.
The following is a link to useful information regarding EMR, Return on Investment:http://www.emrexperts.com/emr-roi/index.php
American College of Physicians (http://www.acponline.org/pmc/ehr.htm)
This is the ACP’s practice management center’s page on EMRs containing useful documents and guides. Some areas may be for members only.
AAFP Center For Health Information Technology (http://www.centerforhit.org/)
For members of AAFP, the ChiT webpage is an excellent place to start as it outlines the complete process of adopting EMRs.
EMR Consultant (http://www.emrconsultant.com/)
A useful site for vendor comparison, forums and blogs on EMR, and an online ‘matching’ program which matches a practice’s needs to EMR solutions.
Healthcare Informatics
(http://www.healthcare-informatics.com/)
This periodical is a great reference for a listing of EMR vendors, the products they offer, as well as their features. Click on "Resource" on the left panel, then choose "EHR" from the list.
Medicare Quality Improvement Community (http://www.medqic.org/) A rather technical and exhaustive resource which is geared more for Quality Improvement Organizations.
The AC Group (http://www.acgroup.org/) AC Group is one of the leading companies, specializing in the evaluation, selection, and ranking of vendors in the PMS/EMR/EHR
healthcare marketplace.
Klas (http://www.healthcomputing.com/) KLAS is a research and consulting firm specializing in
monitoring and reporting the performance of Healthcare's Information Technology (HIT) vendors.
Quality Net (http://www.qualitynet.org/) Established by the Centers for Medicare & Medicaid Services (CMS), QualityNet provides healthcare quality improvement news, resources and data reporting tools and applications used by healthcare providers and others.
DOQ-IT (http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2114&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=false&cboOrder=date) Doctors’ Office Quality – Information Technology. The QIO community is a national network of 53 organizations working under a contract with the Centers for Medicare & Medicaid Services to educate and assist physician offices with EHR system selection and implementation.
Ambulatory Care Quality Alliance (http://www.ambulatoryqualityalliance.org/default.htm)
A coalition of the American Academy of Family Physicians (AAFP), American College of Physicians (ACP), America’s Health Insurance Plans (AHIP), and Agency for Healthcare Research and Quality AHRQ whose mission is to determine how to most effectively and efficiently improve performance measurement, data aggregation, and reporting in the ambulatory care setting.
Centers for Medicare & Medicaid Services (http://www.cms.hhs.gov/pvrp/)
Link to the CMS’s Physician Voluntary Reporting Program.
National Committee on Quality Assurance (http://www.ncqa.org/)
Contains information on the various Physician Recognition Programs.
I hope this information is useful to you.
Wednesday, August 13, 2008
Don't Jump To Implement Wireless Services
Most health systems and clinics move towards the adoption of wireless and mobility as a results of a few major developments in their health care environments, with the objective of improving their clinical staff productivity with anytime, anywhere access to key medical and patient information?
Well, over the years I have ran across many variables that may help your implementation. Of course your approach maybe similar, but read on.
The key business drivers for the integration and adoption of wireless and mobility solution, that I have see are;
- to improve responsiveness and consistency of patient care,
- the reduction of medical errors and litigation risk stems from paper-based manual processes
- an ever-increasing number of patients needing timely/critical care,
- visibility and accountability for patients in real-time,
- and anywhere high-speed access to critical information across the clinical environment.
If your facility falls into any of the above categories, try not to jump right into a solution mode – spend as much time as possible up-front to formulate a strategy, validate your infrastructure requirements, and build a detailed design. The "time spent later on making adjustments or fixing implementation mistakes can be greatly reduced, especially if you have a complex integration".
Secondly, if possible, before you jump in....try to answer the following questions.
1. Can we realistically improve our clinical staff productivity by providing anytime, anywhere access to key medical and patient information?
2. Do we currently have a secure, integrated communications environment that allows our staff to efficiently locate resources and collaborate to provide faster, higher-quality services to your patients?
3. Do we currently have any challenges in delivering key applications that will need to leverage a wireless network?
4. Do we have visibility into the location of staff and medical equipment to ensure availability and security?
5. Do we have a need to integrate our disparate communications systems into a more cost-efficient network?
6. Can our clinicians and caregivers now reliably access critical information using our current devices?
7. What challenges currently exist in managing our end-user environments
Finally, ensure that you meet with nurses, doctors, system vendors, and every key personnel and stakeholders to be sure that you clearly and timely explain the requirements, budget and work/integration that will be involved. Give them enough lead time to provide feedback, recommended changes, update (software/firmware), order new hardware components, etc. which may be required for wireless and mobility integration.
If you have not already gone down this road - every CIO and VP of Finance will one day!
Well, over the years I have ran across many variables that may help your implementation. Of course your approach maybe similar, but read on.
The key business drivers for the integration and adoption of wireless and mobility solution, that I have see are;
- to improve responsiveness and consistency of patient care,
- the reduction of medical errors and litigation risk stems from paper-based manual processes
- an ever-increasing number of patients needing timely/critical care,
- visibility and accountability for patients in real-time,
- and anywhere high-speed access to critical information across the clinical environment.
If your facility falls into any of the above categories, try not to jump right into a solution mode – spend as much time as possible up-front to formulate a strategy, validate your infrastructure requirements, and build a detailed design. The "time spent later on making adjustments or fixing implementation mistakes can be greatly reduced, especially if you have a complex integration".
Secondly, if possible, before you jump in....try to answer the following questions.
1. Can we realistically improve our clinical staff productivity by providing anytime, anywhere access to key medical and patient information?
2. Do we currently have a secure, integrated communications environment that allows our staff to efficiently locate resources and collaborate to provide faster, higher-quality services to your patients?
3. Do we currently have any challenges in delivering key applications that will need to leverage a wireless network?
4. Do we have visibility into the location of staff and medical equipment to ensure availability and security?
5. Do we have a need to integrate our disparate communications systems into a more cost-efficient network?
6. Can our clinicians and caregivers now reliably access critical information using our current devices?
7. What challenges currently exist in managing our end-user environments
Finally, ensure that you meet with nurses, doctors, system vendors, and every key personnel and stakeholders to be sure that you clearly and timely explain the requirements, budget and work/integration that will be involved. Give them enough lead time to provide feedback, recommended changes, update (software/firmware), order new hardware components, etc. which may be required for wireless and mobility integration.
If you have not already gone down this road - every CIO and VP of Finance will one day!
Emotional Intellengence for "Healthcare IT" Professionals
Health care IT and Clinical professionals are somehow trained to troubleshoot and diagnose problems and unexplained situations. We are, by nature, looking for flaws and, consequently, improvement opportunities in every situation. We are trained to see the downside of people health and technology processes, but that doesn't mean we have to carry that perception over into our dealing with our colleagues. Even when you think you are being "honest" or "helpful," doing so does not help in all cases.
Think of people you associate with daily and always find something positive to say about every situation. A project that gets off track is a chance to work on project management and people skills. A sick patient is an opportunity to make them feeling better than when you found them. Whether family, client or colleague, leave an encounter or conversation with them feeling invigorate and positive.
You have a lot of control over the circumstances in which you find yourself. Things happen, to be sure, but you also have a lot of control over how you see others.
Bad days are inevitable; bad attitudes are optional - everyone wins!
Think of people you associate with daily and always find something positive to say about every situation. A project that gets off track is a chance to work on project management and people skills. A sick patient is an opportunity to make them feeling better than when you found them. Whether family, client or colleague, leave an encounter or conversation with them feeling invigorate and positive.
You have a lot of control over the circumstances in which you find yourself. Things happen, to be sure, but you also have a lot of control over how you see others.
Bad days are inevitable; bad attitudes are optional - everyone wins!
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