HealthCareGuy

Effective forms management improves healthcare data quality

Wed, 23 Aug 2017 14:33:34 +0000

When was the last time you thought about the forms strategy in your organization? Most of us think about forms as a clerical activity but proper management of patient forms drives important clinical and business initiatives such as patient satisfaction, patient quality scores, and care coordination analytics. The demand for clinical data and research performed by Healthcare Data Analytics is growing exponentially. With so much emphasis in healthcare put on collecting quality data, information exchange, analytics, patient generated health data, and more, it’s surprising how little attention is put on the way this important information is collected.

Is “cloud security” an oxymoron? Join us at CDW’s #HIMSS17 booth on Monday at 3pm to find out.

Thu, 16 Feb 2017 14:53:30 +0000

Institutions in all industry sectors have made significant IT moves into the cloud (which basically means they’ve outsourced their data centers and server infrastructure). Most companies that have transformed their IT departments to be cloud first are gaining efficiencies and productivity improvements in all areas of IT. Other than being surprised by costs being higher in some cases than they expected, very few IT professionals dislike anything about the cloud enough to go back from cloud to on-premise.

#IBMWoW cognitive solutions for cyber threat analysis and collaboration

Fri, 21 Oct 2016 00:11:54 +0000

I’ll be attending IBM’s World of Watson 2016 in Las Vegas next week. I’m looking forward to hearing whether government and industry are collaborating any better as a result of the passage of The Cybersecurity Act of 2015. The Cyber Act by itself doesn’t really imply (or require) that citizen data (or any other kind of private data) be made accessible across institutions. However, what it does encourage is the sharing of threat or breach data.

Cognitive ushers us from “carbon intelligence” to AI “silicon intelligence”

Thu, 20 Oct 2016 18:01:05 +0000

When the term “artificial intelligence” – better known as “AI” – was initially coined, it was thought that humans (carbon based life forms) had “real” intelligence while the best a machine’s intelligence (to the extent they had any) could get was “artificial”. As I work with companies that are leading major machine learning, algorithms, and AI initiatives I’m convinced that we’re ushering in a new golden age of AI but one that might need some terminology refinements.

Digitally managed clinical trials will accelerate results and reduce costs

Wed, 28 Sep 2016 11:14:19 +0000

Digitally managed clinical trials have the potential to accelerate results report and reduce costs but workflow questions and regulatory questions remain. In many facets of our lives digital data collection has improved services, eliminated errors, and reduced waste in time and resources. Think about the ticketing and check-in process at airports ten years ago vs. today: when airlines put the information in our hands we were able to do the check-in, seat selection, and other work for them.

Health IoT creates huge opportunities for public health and software companies

Fri, 29 Jan 2016 02:15:44 +0000

_It was evident from this year’s Consumer Electronics Show (CES) earlier this month that there’s a great deal of interest in the Internet of Things (IoT) in general and for Health IoT in particular. Given that interest I thought I would reach out to a couple of experts to help explore the IoT landscape. Murali Kurukunda is Director of IT and Lead Architect at Medecision and Dr. _Peter L. Levin, is CEO at Amida, director of ConversaHealth, and a father of the BlueButton initiative (which he helped launch as CTO of VA)__.

Could Apple Store-like digital health retail stores be popular?

Thu, 05 Nov 2015 15:10:34 +0000

As I travel the country speaking at conferences, I’ve had dozens of conversations with smart people who believe there’s a growing consensus that “patient-driven” (or consumer-driven or member-driven) healthcare spending has arrived. Consumer-driven insurance exchanges, high deductible insurance plans and copays are creating more patient payment responsibilities than ever before. So, if patient-driven healthcare spending has arrived does that mean we’re ready for digital health or healthcare insurance retail stores?

Reimbursements red herring, trust, and key infrastructure needs for Telemedicine success

Thu, 29 Oct 2015 03:22:34 +0000

Telemedicine is a growing part of modern healthcare, and could play a pivotal role in the U.S.’s efforts to streamline and expand preventative services. Virtual, video-based doctor’s appointments can help alleviate the general practitioner shortage, and encourage preventative care. They also offer a cheaper, more-convenient alternative to in-person appointments for many patients. Unfortunately, there’s a lot of hype and misinformation being reported so I was pleased to see that TechnologyAdvice (TA) surveyed 504 U.

Impacts we can expect from ICD-10 transition

Thu, 29 Oct 2015 02:47:19 +0000

The nice folks at Ingenious Med reached out to get my opinion on the recent ICD-10 transition. They summarized my thoughts in a recent post on their blog. Their questions reminded me of similar ones I’ve been recently asked so I thought I’d elaborate them here. Q: How will the additional specificity required by ICD-10 pose a challenge for clinicians and the way that they currently track patient information? A: For clinicians with “simple” requirements – such as specialists or those that don’t perform too many different diagnoses or procedures the transition will be annoying but not catastrophic.

How health IT enables safer medical travel and tourism

Sun, 07 Jun 2015 17:33:52 +0000

IT innovation, global medicine and frustrated medical patients drive the demand for medical travel. But telemedicine also improves patient care and the customer experience of medical travelers. Once again, we welcome medical IT entrepreneur, Agha Ahmed, Managing Partner of GHIMBA, as we explore how IT innovations help patients get high-quality healthcare outside of the USA. How do IT innovations help provide services that medical travelers can benefit from? IT helps deliver safe medical care and a pleasant trip to facilities overseas.

HealthIMPACT Southwest recap: CIOs think dashboards need significant improvement

Tue, 26 May 2015 11:26:18 +0000

I chair the HealthIMPACT series of events that is held in a variety of cities throughout the year. HealthIMPACT is a no-nonsense and “No BS” local one-day event for busy health IT professionals that pretty much know what they’re doing but are looking to learn from their peers (instead of professional presenters). We don’t try to add further hype to common trends everyone’s already seen many times or explain the obvious to make ourselves look smart; we explain the implications of trends to your daily work, figure out how to operationalize innovations, and provide actionable advice so that you can do your job better.

How health IT can deliver on the promise of Medical Travel

Mon, 18 May 2015 18:49:14 +0000

Health IT for large systems, hospitals, and traditional physician practices is well underway. Enough so that innovators/startups, are starting to see consolidation and heavy competition. As I look around at new areas for health IT implementations, I think areas in medical travel or medical tourism (“MT”) appear to be great opportunities. A potent mix of the Internet, cloud computing and globalized medicine — when combined — should drive medical travel. I’ll be speaking at the Medical Travel and Global Healthcare Business Summit in Tampa Florida.

Shahid’s No BS guide to patient engagement at #HIMSS15

Sun, 12 Apr 2015 13:46:08 +0000

I’ll be at #HIMSS15 in Chicago this week and am preparing for the onslaught of the term “patient engagement”. It’s both overused and ill-defined which means it’s almost meaningless as a category of technology or approaches. It’s also multi-faceted which means a definition is not going to be forthcoming soon; so, I’m not going to try. As I go through the educational sessions and exhibits looking at patient engagement solutions, I’m going to be trying to figure out how to categorize them.

Evaluating and choosing healthcare cloud services providers

Tue, 31 Mar 2015 12:02:35 +0000

As healthcare moves from on-premise to cloud services, the evaluation and selection of “HIPAA compliant” cloud service providers becomes an import task. I don’t like the description “HIPAA compliant” because it’s imprecise and not meaningful. However, it’s something that many non-technical people look for when evaluating providers so I’m using it here. My friend Alex Ginzburg, VP of Technology at Intervention Insights, and I have done this kind of healthcare cloud services providers evaluation and selection many times so it was natural for me to reach out and ask him to provide some guidance for the community.

Congress finally getting serious about telemedicine, but are CDOs ready?

Fri, 20 Mar 2015 18:21:09 +0000

The latest ‘doc fix’ bill, H.R. 1470, was introduced last week. Though it has quite a ways to go before it’s sent to conference or passed, the bill has some pretty nice language for telemedicine and care coordination enthusiasts. Though it’s probably less than I would like, Section 4 (Encouraging Care Management for Individuals with Chronic Care Needs) is a great start. The telehealth language is pretty general but I like how it is making sure that telemedicine isn’t precluded from being reimbursed.

Social selling of Medical Devices is hard but necessary

Fri, 13 Mar 2015 00:08:30 +0000

Social selling of Medical Devices is something we don’t talk enough about because it’s hard. That’s going to change soon. You’re probably aware that John Lynn and I are co-chairing the exciting 2nd iteration of the Healthcare IT Marketing & PR Conference (“HITMC”) in May. What you’re probably not aware of is that we’re expanding the audience and sessions to include non-traditional healthcare IT participants — specifically medical device manufacturers. I believe that the distinction of health IT or digital health marketing vs.

Entrepreneurs must integrate mission-driven strategic investors

Sun, 08 Mar 2015 17:19:27 +0000

Last week I wrote about how federated groups of investors help de-risk innovations in the Venture Development Lifecycle (VDLC). Yesterday I elaborated on how entrepreneurs can understand risk through various funding cycles. One of the most important investors we didn’t talk about in the VDLC was the strategic investor (what I like to call the mission-driven investor) . Mission-driven strategics view risk differently and entrepreneurs should create investor journey maps to take them into account.

Patients say deploying a patient portal isn’t enough to engage them

Wed, 04 Mar 2015 12:30:25 +0000

Much has been made of the push to better engage patients, but little has been spent on examining exactly what patients want. Despite the requirements set by the EHR Incentive Program, simply deploying a patient portal isn’t enough to engender real, sustainable engagement. Recently TechnologyAdvice surveyed 409 adult Americans about their digital health services preferences. I really like the surveys they run so I reached out to Zach Watson, the healthcare IT content manager at TechnologyAdvice, to see what health providers, entrepreneurs, and innovators could learn from the results.

Digital health startups should de-risk using strategically integrated investors

Tue, 03 Mar 2015 14:25:01 +0000

I have the pleasure of meeting or speaking with many digital health, health IT, medTech, and life sciences (especially genomics and bioinformatics) startups every week. As a serial entrepreneur and angel investor myself I know how hard it is these days to get to product/market fit while working with top-notch investors who understand how to help scale a business. Last week I wrote about how strategically integrated investors help de-risk innovations and I got some great questions via e-mail about how cofounders and startups should go about seeking such investors.

Is digital health innovation overrated?

Tue, 17 Feb 2015 13:48:26 +0000

Our next HealthIMPACT CIO Summit will take place next Friday, February 27th, 2015**,** at the Union League Club in New York. Our conversation kicks off in the morning with Ed Marx, SVP & CIO at Texas Health Resources and 2014 IW Healthcare CIO of the Year, and Michael Restuccia, VP & CIO at University of Pennsylvania Health System. I will be interviewing Ed and Michael together on stage and we’ll focus on how to establish a process that will embed successful innovation into the culture of an organization.

7 digital health innovations and investments for 2015

Tue, 17 Feb 2015 12:27:46 +0000

The folks from HP Matter digital magazine wanted to know where I thought digital health startups, product innovators, and venture capital investors should be pointing their attention in 2015. These are some of my technology and healthcare predictions: CMS’s request for information (RFI) on new primary care models bears innovative fruit. Interoperability will move beyond talk and into sustainable business models and real technology. The healthcare ecosystem should be able to create lasting patient benefits.

Who should be held accountable for risk management and cybersecurity in healthcare institutions?

Thu, 22 Jan 2015 18:47:22 +0000

_I’ve been involved in building many life-critical and mission-critical products over the last 25 years and have found that, finally, cybersecurity is getting the kind of attention it deserves. We’re slowly and steadily moving from “HIPAA Compliance” silliness into a more mature and disciplined professional focus on risk management, continuous risk monitoring, and actual security tasks concentrating on real technical vulnerabilities and proper training of users (instead of just “security theater”).

Second annual Healthcare IT Marketing Conference (HITMC)

Mon, 15 Dec 2014 08:34:11 +0000

John Lynn, prolific blogger and health IT media magnate, and I are teaming up again for the second year to produce and deliver a marketing conference focused on helping digital health, health IT, and medical device innovators. We’re going to be providing actionable advice and specific techniques you can use to cut through the noise when trying to market healthcare and medical tech products to physicians, hospitals, health systems, ACOs, patients, and similar customers.

Is Meaningful Use working and what can innovators do to help with EHR adoption?

Sun, 09 Nov 2014 08:38:09 +0000

Earlier this year NueMD created a nice looking Meaningful Use Infographic — asking the question whether MU was helping or hurting EHR Adoption. I loved the summary but I wanted to dig in a little further so I asked Dr. William Rusnak, a resident physician in radiology and a healthcare IT writer for NueMD, to tell us what that infographic meant for innovators and folks building solutions. Here’s what Dr. Rusnak said:

Health IT and digital health job opportunities, qualifications, and certification benefits

Sun, 26 Oct 2014 07:44:40 +0000

I’ve written a number of articles and a few video interviews on job opportunities in digital health recently and have received a steady stream of questions since then. Given healthcare IT professionals can make $90,000 or more annually, there has been growing interest in the industry. To help separate fact from fiction and dive a little deeper in to the realities of these opportunities, I reached out to Beth Kelly, a freelance writer from Chicago, IL to summarize the projected outlook for specialized positions within the field of health IT.

Health-focused wearables have a chance of improving patient care if innovators craft solutions plus providers and insurers work together to incentivize and pay for them

Mon, 20 Oct 2014 07:45:41 +0000

I’ve been interested in the new “wearables” segment for a while. I reached out to Cameron Graham, the managing editor at TechnologyAdvice where he oversees market research for emerging technology, to give us some evidence-driven advice about wearables that entrepreneurs, innovators, healthcare providers, and payers can use for decision making. Specifically, what does the current research show and what are the actionable insights for how to incentivize patients to use them and figure out why patients might pay for them?

Top 9 Insights for patient-centric Digital Health Innovators from the ENGAGE conference

Mon, 13 Oct 2014 07:48:22 +0000

MedCityNews invited me to attend their ENGAGE “Innovation in Patient Engagement” Conference and I found the content, speakers, and overall quality quite good. Since I chair several conferences every year I know how hard it is to pull off a good one so I’d like to congratulate MedCityNews for pulling off a great event. The goal of the ENGAGE was to highlight the importance of patient awareness and engagement in developing and managing novel digital health innovations.

The difference between User Stories and Software Requirements Specifications (SRS), especially for regulated systems (part 1)

Fri, 10 Oct 2014 07:52:30 +0000

It’s getting easier and easier to build unregulated software these days but it’s still pretty hard to create regulated/certified systems such as EHRs, medical device software, and government IT. To help create better systems we all know we need better user requirements; however, “heavyweight requirements” efforts have been shunned, especially in unregulated systems, over the past decade in favor of “user stories” and more agile specifications. But, are agile user stories the best way to go in regulated systems where requirements traceability and safety analysis is a must?

When you’re looking to buy or replace your EHR, follow these common sense Dos and Don’ts for comparing EHR software

Wed, 01 Oct 2014 07:58:25 +0000

By some accounts, almost 30% of EHR users will be interested in replacing their software as they move from Meaningful Use Stage 1 to 2 to 3 over the next few years. Although I’ve written and spoken extensively in the past about how to make sure you pick the right digital health and EHR software, I wanted to put together a new “common sense” type of Do’s and Don’ts list for picking new EHR software.

Patient portals have a future as a patient engagement tool if clinicians are on board and encourage their use

Tue, 30 Sep 2014 08:04:25 +0000

I wrote my first patient portal site, built into my first EMR software, back in 1998. At that time I mistakenly thought that portals would take off and patients would embrace them. What I quickly learned was that patient portals aren’t really portals in the sense of Yahoo! or Google but enterprise software’s customer-facing front-ends. The enterprise software in this case is of course an EHR and the customers are the patients.

How to improve your SRS by distinguishing between vague and ambiguous requirements in health IT and medical device systems

Sun, 28 Sep 2014 08:05:57 +0000

Because it’s so easy to build software these days we’re seeing a proliferation of healthcare apps — what’s hard to figure out is whether we’re building the right software. Abder-Rahman Ali, currently pursuing his Medical Image Analysis Ph.D. in France, has graciously agreed to give us advice on how to write good software specifications for health and medical technology solutions. Some of you are probably rolling your eyes and thinking that software requirements specifications (SRS) are old and “tired” and we should be writing agile user stories instead.

ENGAGE can help pharma and biotech learn how to benefit from patient engagement

Fri, 26 Sep 2014 08:07:20 +0000

Patient engagement is something that physicians have done for thousands of years as they cared for patients (whether going to their homes or having them come to hospitals or clinics). With new digital health technologies the way providers can engage with patients is changing significantly but we’re not quite sure about the best ways to apply that technology. This is why I’m looking forward to attending MedCityNews.com’s ENGAGE conference next week in Washington, DC.

The future of medicine and the incredible innovations we can expect by 2064

Thu, 25 Sep 2014 08:09:43 +0000

The Fred Alger Management team reached out to me recently asking what innovative changes I thought the medical and healthcare industry will be going through over the next 50 years. It was for their innovative “Think Further” series: [youtube=https://www.youtube.com/watch?v=iOgt85cPU8Q&list=UUcpr1hudOhiPOsj-7rwe8Ew&w=520] As Yogi Berra famously quipped “It’s tough to make predictions, especially about the future” but Alger’s “Future of Medicine” question is an interesting approach to generating ideas so I thought I’d give it a shot.

Top Ten Insights for Digital Health Innovators from the Next Generation Point of Care Diagnostics Conference

Mon, 01 Sep 2014 08:10:49 +0000

Cambridge HealthTech Institute (CHI) invited me to attend their Next Generation Point of Care Diagnostics Conference and I came away thoroughly impressed with the content, speakers, and organization. Since I chair several conferences a year I know how hard it is to pull off a good one so I’d like to thank CHI for a job well done. Goals & Attendees The goal of the event was to provide a progress update to the healthcare industry on the advances in next generation point-of-care (POC) diagnostics while highlighting the advent of innovative platforms and use of digital information systems to aid in the development of novel POC diagnostics.

Encryption at rest and encryption in transit for HIPAA compliance are not easy questions to answer

Fri, 29 Aug 2014 08:24:01 +0000

Given the number of breaches we’ve seen this Summer at healthcare institutions, I’ve just spent a ton of time recently on several engineering engagements looking at “HIPAA compliant” encryption (HIPAA compliance is in quotes since it’s generally meaningless). Since I’ve heard a number of developers say “we’re HIPAA compliant because we encrypt our data” I wanted to take a moment to unbundle that statement and make sure we all understand what that means.

How to tackle vague requirements in health IT and medical device software using fuzzy logic and storytelling

Thu, 21 Aug 2014 08:25:06 +0000

These days it’s pretty easy to build almost any kind of software you can imagine — what’s really hard, though, is figuring out what to build. As I work on complex software systems in government, medical devices, healthcare IT, and biomedical IT I find that tackling vague requirements is one of the most pervasive and difficult problems to solve. Even the most experienced developers have a hard time building something that has not been defined well for them; a disciplined software requirements engineering approach is necessary, especially in safety critical systems.

Learn how to operationalize new health IT wisdom at HealthIMPACT Midwest in Chicago on September 8

Wed, 20 Aug 2014 08:26:30 +0000

Our vision of providing a series of packed one day events focused on practical, relevant, and actionable health IT advice were very well received in Houston, NYC, and Santa Monica earlier this year. Our next event is in Chicago and we’re going to continue to eschew canned PowerPoint decks which limit conversations and instead deliver on the implications of major trends and operationalizable advice about where to successfully apply IT in healthcare settings.

To improve patient satisfaction, hospital supply chain units need better IT and next generation technology

Sun, 17 Aug 2014 08:27:53 +0000

I’ve been looking at hospital supply chain automation and the IT surrounding it for a number of years now. Starting with Cardinal Health but then moving on to help a number of other vendors in the space, I’ve felt that there’s not been enough next-generation tech being applied to the low margin, high volume business of hospital supply management. Hospitals often spend tens of millions of dollars on EHRs and other IT systems that have little direct cost reduction capability but they ignore, often at their peril, supply management systems that can save immediate dollars.

Guest Article: OLAP remains a great healthcare analytics architecture, even in the Big Data era

Thu, 14 Aug 2014 08:29:54 +0000

I’ve been getting many questions these days about big data tools and solutions, especially their role in healthcare analytics. I think that unless you’re doing large scale analysis of biomedical data such as genomics, it’s probably best to stick with traditional tried and true analytics tools. Online Analytics Processing (OLAP) can be invaluable for medical facilities to use when interpreting data and health informatics because most of that data is in relational, key-value, or hiearchical databases (such as MUMPS).

What EHR/PM vendors should do as 63% of buyers look to replace existing PM solutions

Wed, 23 Jul 2014 10:29:51 +0000

Melissa McCormack, a medical researcher with EHR consultancy group Software Advice, recently published their medical practice management BuyerView research, which found that 63% of the buyers were replacing existing PM solutions, rather than making a first-time purchase. This mirrors the trend we’ve seen across medical software purchasing, where the HITECH Act may have prompted hasty first purchases of EHR solutions, followed by replacements 1-2 years later. For PM vendors, this means there’s a huge opportunity to market your products to practices as an upgrade, even if they’re already using PM software.

Guest Article: HL7 FAQ and why exchanging critical patient data isn’t a nightmare

Sun, 06 Jul 2014 20:44:06 +0000

I recently saw a demo of the Decisions.com platform and left impressed with the workflow engine, business rules execution, forms automation, and data integration platform. I’m very familiar with almost all the major HL7 routers and integration engines out there but Carl Hewitt, Founder and Chief Architect at Decisions, is releasing something fairly unique — an visual HL7 interface definition and integration platform for use by analysts and non-technical personnel charged with healthcare data connectivity across business workflows.

Guest Article: What EHR buyers and health IT vendors can learn from the Nashville market

Sun, 06 Jul 2014 20:11:48 +0000

Zach Watson over at Technology Advice.com wrote a nice piece on EHR Trends in Nashville. I’m not a big fan of “trends” articles because trends aren’t that important, the implications of those trends and how to operationalize the implications are most important. I enjoyed Zach’s article so I asked him to tell us what those trends mean for EHR buyers and health IT vendors writ large. Here’s what Zach said:

Guest Article: Is Patient Generated Health Data (PGHD) trustworthy enough to use in health record banks?

Sun, 18 May 2014 14:07:35 +0000

The push towards shifting the patient’s role from a passive recipient of care to an active member of the care-team looks set to gain further legislative backing. Earlier this year, the Health IT Standards Committee, along with The Joint Commission and ONC, laid out recommendations for integrating patient generated health data (PGHD) into Stage 3 Meaningful Use requirements. To see what this might mean to health IT and med tech vendors, I reached out to Zach Watson of TechnologyAdvice, who covers EHR related news, along with business intelligence, and other topics.

There’s no difference between mHealth & telemedicine, come to ATA May 17-20 in Baltimore to learn more

Thu, 08 May 2014 20:51:21 +0000

I’ll be heading to the American Telemedicine Association (ATA) annual conference in Baltimore in a couple of weeks. To see what I might learn there I interviewed Jon Linkous, CEO of ATA. The first question I asked him was “what’s the difference between mHealth and telemedicine?” Basically nothing, he said — but, he noted that the mobile health or mHealth movement and nomenclature has been very useful to the telemedical industry and he welcomed the comparisons.

Consolidation and other insights from the 2014 Meaningful Use EHR Market Share Report

Mon, 05 May 2014 00:29:01 +0000

EHR review site Software Advice recently published their 2014 Meaningful Use EHR Market Share Report (a SlideShare version is also available). They reported that in contrast to the buzz about this impending market consolidation, they found a trend toward fragmentation; in fact, the number of vendors in the health space with MU attestations actually grew 25% in the past year alone. The report was nice enough that I reached out to Melissa McCormack from Software Advice to see what further insights we could glean from the report.

More practical, relevant, and actionable health IT advice to be doled out at HealthIMPACT East in NYC on Wednesday

Sun, 27 Apr 2014 18:12:27 +0000

Our vision of providing a packed one day event focused on practical, relevant, and actionable health IT advice was very well received in Houston earlier this month. We wanted to focus not on canned PowerPoint decks and promotion of tech hype but specific advice on how and where to apply IT in healthcare settings. Based on some of the feedback we got, it looks like we struck a chord: “I did enjoy the HealthIMPACT Forum in Houston and will definitely recommend attending.

Guest Article: Secure message exchange using the Direct Protocol is not a myth, there really are people using it

Mon, 14 Apr 2014 21:44:22 +0000

I recently chaired a couple of conferences and my next HealthIMPACT event is coming up later this month in NYC. At each one of the events and many times a year via twitter and e-mail I am asked whether the Direct Project is successful, worth implementing in health IT projects, and if there are many people sending secure messages using Direct. To help answer these questions, I reached out to Rachel A.

Anecdote-driven systems engineering and complaint-based interoperability design will not solve health IT woes

Thu, 27 Mar 2014 17:52:58 +0000

As I’ve been preparing to chair the HealthIMPACT conference in Houston next Thursday I’ve been having some terrific conversations with big companies like Cisco, some of our publishing partners, and smaller vendors entering the health IT space for the first time. One great question I was asked during a discussing yesterday by a tech publisher was “so what’s it going to take to achieve real interoperability in healthcare and how long will it take?

What does it take to get beyond hype in health IT and focus on valuable, actionable, practical, relevant content?

Thu, 20 Mar 2014 18:17:40 +0000

My friend John Lynn was kind enough to cover the new HealthIMPACT Conference that I’m chairing in Houston on April 3 in his recent piece entitled “Getting Beyond the Health IT Cheerleaders, BS, and Hype Machine“. While the article was great, Beth Friedman’s comment was priceless: What are the criteria to be considered part of the cheerleader squad? This PR agency wants to be sure we are providing valuable, actionable, [practical], relevant content….

Help us make sure HealthIMPACT events are useful and actionable

Fri, 07 Mar 2014 21:00:08 +0000

This year I’m chairing a healthcare IT event series called HealthIMPACT — it’s what I’m hoping will be some of the best places for healthcare technology enthusiasts and buyers to get actionable advice on what’s real, what’s BS, what to buy, what not to buy, and perhaps most importantly, which guidance is worth following. In order to make sure we cover the right topics, we have created a very short survey so that we have some evidence-driven approaches to proving we’re focusing on the right areas.

Learn how to cut through the noise at the first ever Health IT Marketing Conference

Wed, 05 Mar 2014 01:09:10 +0000

John Lynn, prolific blogger and health IT media magnate, and I are teaming up to produce and deliver the world’s first marketing conference focused on helping innovators cut through the noise when trying to market their healthcare and medical tech products to physicians, hospitals, and similar customers. Called The Healthcare IT Marketing Conference, it will cover very important subjects by some of the world’s best experts on those topics. Learn how to align the Payers, Beneficiaries, and Users (PBU) of your Health IT or MedTech product

Meet up with me at my HIMSS’14 sessions and events

Sat, 22 Feb 2014 00:31:00 +0000

I’ll be leaving for HIMSS’14 on Saturday and plan to be around for meetings and sessions from Sunday through Wednesday. Here are some of the places I plan to be, catch me if you’re around: Sunday — covering the Venture Forum, CHIME, and special sessions. Heading to Susquehana Equity Capital cocktail party in the evening. Monday — covering a number of companies and speaking at two sessions, private dinner 3:30p speaking on Social Media and Influence at HIMSS Spot 4:30p speaking on data interoperability at SureScripts booth 2918 Tuesday — covering a number of companies and speaking at one session 11:00am speaking on Developer Platforms for Next Generation Healthcare Apps, room 209C 6:00pm hosting the New Media Meetup with John Lynn Wednesday — numerous meetings and events, finalizing coverage of companies

Join Stericyle Communication, John Lynn, and Shahid at the HIMSS’14 New Media Meetup

Tue, 18 Feb 2014 02:12:59 +0000

John Lynn and I are hosting the 5th Annual New Media Meetup next week at the HIMSS Conference. This year’s HIMSS tradition is sponsored by Stericycle Communication Solutions. Thanks to Stericycle’s generous participation, John and I can host, quench the thirst of, and feed our New Media friends at Tommy Bahama Pointe, just a short walk from the convention center. We’ve come a long way from our first “meet the bloggers” event in Atlanta and we’re thrilled to have this “wooden anniversary” of the New Media Meetup which has expanded well beyond just bloggers.

Keeping medical device designs relevant in a big data world migrating to outcomes-driven payment models

Mon, 17 Feb 2014 19:17:06 +0000

Last week I presented the closing keynote at the Medical Design & Manufacturing (MD&M) West Conference & Exhibition in Los Angeles. MD&M has always been about what’s next in medical device design and this year’s event didn’t disappoint. While still being primarily focused on hardware, many smart device manufacturers came out to MD&M looking for advice on next generation architecture and thinking so that they could point their product roadmaps in the right direction.

Why do Avon sales reps selling makeup deserve better usability than hospital physicians saving lives?

Mon, 03 Feb 2014 02:25:34 +0000

I was watching the Super Bowl tonight and lost interest after Bruno Mars’ very nice halftime concert so I started picking up some “Read it Later” articles I saved late last year; one specifically caught my eye. In December the Wall Street Journal (WSJ) reported that Avon is pulling the plug on a $125 million software system rollout which “has been in the works for four years after a test of the system in Canada drove away many of the salespeople who fuel the door-to-door cosmetics company’s revenue”.

Moving from paper-native to digital-native requires disciplined Healthcare Information Lifecycle Management (ILM)

Sun, 02 Feb 2014 19:25:47 +0000

We’re all familiar with the idea that medicine is, slowly but surely, going from a paper-native to a digital-native industry. Most of our processes and procedures were designed in an environment where information started on paper and then was either scanned as a PDF document or entered into a structured electronic record in some software. Our current processes assume that if our software systems ever failed, we have paper records and could continue standard medical care without the electronic versions for a period of time.

Join me and other cheerleaders at the “Driving demand for Healthcare Interoperability” Pep Rally this Thursday in DC

Sun, 02 Feb 2014 16:00:51 +0000

When I was growing up in Texas I remember that we used to have Pep Rallies before our major sporting events. The idea behind a pep rally is to get the juices flowing and get fans engaged and cheering for the home team. On Thursday this week the West Health Institute and the ONC are hosting “Health care Innovation Day, HCI-DC 2014: Igniting an Interoperable Health Care System” where the purpose is to get people cheering for interoperability between EHRs, health IT systems, medical devices, and related technologies.

If Meaningful Use disappeared, how would EHR vendors change their products?

Sat, 01 Feb 2014 02:39:20 +0000

I’ve often said that Meaningful Use and the HITECH Act created false demand for EHRs and has (perhaps irrevocably) harmed innovation in the EHR space by standardizing features and function rather than outcomes and expectations. It’s a false demand because it concentrated too much on prescriptive, sometimes useless, and in many cases productivity-killing, functionality instead of focusing on what’s really needed — data interoperability and fostering innovation. John Halamka wrote something similar recently in his Advice to the new ONC chief (highlights in red below are mine, not John’s):

The causes of digital patient privacy loss in EHRs and other health IT systems

Sun, 26 Jan 2014 21:55:24 +0000

This past Friday I was invited by the Patient Privacy Rights (PPR) Foundation to lead a discussion about privacy and EHRs. The discussion, entitled “Fact vs. Fiction: Best Privacy Practices for EHRs in the Cloud,” addressed patient privacy concerns and potential solutions for doctors working with EHRs. While we are all somewhat disturbed by the slow erosion of privacy in all aspects of our digital lives, the rather rapid loss of patient privacy around health data is especially unnerving because healthcare is so near and dear to us all.

HIMSS ’14 YourTurn is a conference customization option for unconference lovers

Sun, 26 Jan 2014 21:01:03 +0000

Events such as the annual HIMSS Conference take months to plan and properly execute which means that some topics and subject areas that are being covered at the conference might not be as timely as they could be. Also, event planners and selection committees choosing topics for keynotes and presentations do a pretty good job at picking the sessions they think will be the most widely applicable to a large audience.

Guest Article: Digital health doesn’t stop with Meaningful Use, claims and payment technologies still matter

Mon, 13 Jan 2014 01:49:23 +0000

“Digital Health” is often centered on EHRs and Meaningful Use to the detriment of many other technologies that can help improve patient satisfaction. To help make sure that we don’t forget how useful modern technologies are to actually getting paid for medical services, I invited Jay Fulkerson, president and CEO of Health Payment Systems (HPS), to take us through the most important issues surrounding claims and payment tech. Prior to his role at HPS, Fulkerson served as chief executive officer of Touchpoint Health Plan (which was acquired by United Healthcare) so he knows the payment space pretty well.

No, installing an MU certified EHR does not mean you’ll be document-free or paperless

Wed, 20 Nov 2013 19:35:32 +0000

As I travel and speak with physician practices and hospital execs about health IT, I often hear questions about how practices can become paperless as they transition from manual to electronic processes. For those of you that have installed EHRs, you know that going digital does not mean that you’ll be paperless and you’ve probably had to buy more scanners and printers than you originally planned. For those of you that haven’t installed your EHR you’re probably puzzled so let me take a moment to explain why you shouldn’t believe vendors that tell you that you can be completely document-free or paperless in your environment.

The connected EHR, cooperative med devices, and accountable tech are the future of health IT

Fri, 15 Nov 2013 02:28:38 +0000

Earlier this week I spoke at Atlanta Healthcare IT Leadership Summit on Accountable Care Organizations (ACOs) and what I call “accountable tech“. I was pleasantly surprised to learn most of the audience agreed that ACOs can’t succeed without the right technology but am continuously disappointed as to how little we as an industry are doing about it. Accountable tech is health IT that truly enables the slow but emerging move from fee for service (FFS) based payments to value-driven and outcomes based payments.

Guest Article: When Things Go Wrong, The Caterer Gets The Blame

Mon, 11 Nov 2013 14:24:00 +0000

Carl Bergman, a seasoned systems analyst and project manager, is Managing Partner of EHRSelector.com and has been sharing a number of ideas for improving EHR usability with me via email. Since I loved his enthusiasm and agreed with his ideas, I invited Carl to share with us some more detail around how to improve the EHR user experience. Here’s what Carl had to say: Earlier this year, we went to an outdoor wedding.

Why is there a lack of sophisticated UX, usability, and UI discipline in the current design of safety-critical apps and devices?

Thu, 24 Oct 2013 13:41:08 +0000

A friend of mine, a User Interaction (UI)/User Experience (UX) designer and a usability expert that is doing some work at a technology-based medical device client, wrote to me wondering why many medical device companies don’t have much of a UX/UI and usability focused discipline in their marketing and product design teams. The simple reason is that many device manufacturers are still following top-down monolithic processes like waterfall instead of more agile processes that allow feedback-driven requirements definition.

Join me next week for a free webinar where I answer “How do we get beyond Meaningful Use rhetoric and ‘disruption in healthcare’ bloviation and into actionable innovation?”

Mon, 21 Oct 2013 18:14:24 +0000

I speak at many of conferences and webinars each year and I have been hearing that attendees and audiences are starting to get tired of hearing about big data, Meaningful Use, and ‘disruption in healthcare’ topics without more actionable advice. Many entrepreneurs and speakers at the events are still focusing on why technology and IT solutions are helpful in healthcare but customers are more sophisticated these days and they want to know more about how to apply that knowledge into their daily routines.

Join me at the fifth annual Medical Device Connectivity Conference Nov 21-22 in DC (discount ends Monday)

Sat, 19 Oct 2013 15:34:43 +0000

Now that Meaningful Use and ICD-10 are starting generate useful clinical data, it’s clear that electronic structured data in health and medicine is here to stay. One of the major missing pieces of the EHRs puzzle is direct integration of sensor-driven medical device data that can be used for both retrospective and prospective analysis. Many people believe that medical device data, like lab data, should be directly integrated into modern electronic health record solutions but that’s not happening as fast as many of us would like.

Summary report from O’Reilly’s Strata Rx (“data in healthcare”) Conference

Tue, 08 Oct 2013 12:58:12 +0000

Last week I spoke at O’Reilly’s StrataRx Conference in Boston and like all O’Reilly events is was full of great content, terrific networking opportunities, and run with precision. My friend and O’Reilly editor Andy Oram wrote a great blog post summarizing the event and it’s worth reading: “Ticking all the boxes for a health care upgrade at Strata Rx – What is needed for successful reform of the health care system?

Why the health IT industry can accommodate hundreds of EHR solutions without major differentiation

Tue, 08 Oct 2013 10:24:42 +0000

A few days ago Harvard Business Review’s Blog Network published “You Can Win Without Differentiation” and it reminded me of the many lectures I’ve given over the past few years on why the health IT industry tolerates hundreds of EHR and EMR companies that don’t really differ much from each other. A key point made in the article was: The trick is that when there is uncertainty about the quality of a product or service, firms do not have to rely on differentiation in order to obtain a competitive advantage.

Video: where I see health IT data today and where it’s probably going

Mon, 23 Sep 2013 10:01:19 +0000

The nice folks at Iron Mountain, a publicly traded storage and information management services company, reached out to me during the summer and asked what I think the challenges are around healthcare data management. They recorded my answers in a series of interviews published as part of National Health IT Week (Sep 16th-20th). Here’s the first of the series: Many of you probably already know Iron Mountain as a records management, data backup and recovery, document management, and secure shredding company because they’ve been doing that kind of work for years across many different industries.

Guest Article: Creating a Culture of Adoption for EHRs and Health IT

Mon, 09 Sep 2013 22:35:48 +0000

It is general knowledge among seasoned EHR implementers that EHR technology is not the primary concern when promoting EHR adoption (while there are many areas of potential improvements, the tech is generally “good enough” in most cases). There are, however, many challenges surrounding the deployments EHRs and one of the biggest is that not enough training or pre work done to prepare staff and resources. A great way to ensure EHR success is by creating a “Culture of Adoption,” which is something I discussed at length with my friend John Lynn after he attended a recent “think tank” style event hosted at TEDMED by the Breakaway Group (a Xerox Company).

Thoughts on HIT (technical) certifications vs. graduate degrees

Wed, 03 Jul 2013 17:12:20 +0000

These days I’ve been getting an increasing number of questions from some very smart readers of this blog about whether or not graduate degrees or technical (HIT-specific or otherwise) certifications are worth the effort. I’ve written a few posts recently on similar topics and those are worth reviewing: Check out these videos if you’re looking for healthcare IT jobs The realities of getting a job in healthcare IT How to get a job in healthcare IT when you don’t have specific experience My view on HIT (or other technical) certifications The last post in the list above goes into specific detail about what I think about certifications but I didn’t talk much about graduate degrees so I’ll elaborate a bit more on that here.

How liability distribution is holding back certain types of innovation in healthcare

Sat, 15 Jun 2013 16:13:59 +0000

I recently posted about my upcoming Healthcare Unbound presentation on why healthcare disruption is happening too slowly and requested some thoughts from my readers. This morning I woke up to receive these terrific remarks from Jeroen Bouwens which I’m sharing with permission: My theory as to what is holding back certain types of innovation in healthcare is the idea of distributing liability. As long as the ultimate responsibility, and therefore liability, lies with the Medical practitioner, they are extremely reluctant to accept automated systems making medical decisions.

Guest Article: Shakespeare in Namespace, or why Blue Button took off as fast as it did

Sat, 15 Jun 2013 15:05:24 +0000

I had the privilege of working with Dr. Peter Levin as an outside technology strategy adviser while he was the Chief Technology Officer (CTO) of Veterans Affairs during the first Obama Administration. Peter’s a hard-charging, fast-moving, take-no-prisoners style senior technical executive; he was an entrepreneur, professor, and engineer long before he came into government so it was no surprise that he was able to accomplish a great deal during his tenure as the CTO of VA.

Writing safety critical software using an agile, risk-based, approach should be the norm in modern medical device development

Sat, 15 Jun 2013 02:55:51 +0000

I first started using and mentoring developers on agile software development techniques like eXtreme Programming (XP) and Scrum over a decade ago. Often called “lightweight” methodologies, agile software development lifecycles have been generally misunderstood as lacking enough rigor and sophistication to be used in safety-critical systems. Many have erroneously assumed that Agile, Scrum, and related methodologies can’t really be implemented in risk-focused “important” industries like medical devices because they believe only classic waterfall will be accepted by the FDA.

Getting beyond the hype of disruption in healthcare and focusing on actionable innovation

Thu, 13 Jun 2013 23:08:53 +0000

I’ve been invited to give a keynote talk at the Tenth Annual Healthcare Unbound Conference taking place in Denver on July 11-12. Healthcare Unbound is the “granddaddy” of recent Health 2.0, Connected Health, and similar Health Tech conferences. What I love about this specific conference, which I’ve only spoken a few times, is that for a decade now it’s focused on patient engagement, consumer-centric health, and connected health well before it was sexy and fashionable.

Guest Article: Achieving product simplicity in healthcare offerings is hard but possible

Thu, 13 Jun 2013 15:13:08 +0000

_I’m a geek and proud of it — I love building software, launching new products, and am a fan of others that do it well. Recently I ran across the Berlin-based team from kenHub, a site focused on teaching anatomy online and helping medical students prepare for tests. I reached out to the team to ask them how they were differentiating themselves from the many other solutions available they said their goal was to simplify the process of learning using new didactic concepts to focus on memorizing and gamification elements to make it fun and engaging.

Guest Article: Iterative funnel management improvement to reduce health IT sales failures

Tue, 28 May 2013 00:05:38 +0000

A frequent question I am asked by startups and their software focused leadership teams is, “how do we generate sales and what is the appropriate process to follow in creating our sales expectations.” My friend Steve Carbonara has been selling software to healthcare enterprises for years so I asked him to write a companion to his piece on_ __selling to hospitals. Steve is currently the Chief Sales Officer at Cohealo, Inc.

Join me at MedCity ENGAGE: Unlocking Patient Engagement through Innovation, June 5-6, in Washington DC

Mon, 27 May 2013 14:53:57 +0000

Digital Patient Engagement (DPE) is a subject that’s been getting a great deal of attention these days, notably because MU Stage 2 specifically mentions DPE as a requirement for the next generation of certified EHRs. Personally I believe Patient Engagement is still confusing to most people and is probably in the Peak of Inflated Expectations phase of the Gartner hype cycle (another way to think about it is that the DPE noise level is probably much higher than useful signals coming out of the industry).

Guest Article: How to improve health IT products sales into physician practices and hospitals through better funnel management

Mon, 06 May 2013 15:48:28 +0000

_A frequent question I am asked by startups and their software focused leadership teams is, “how do we generate sales and what is the appropriate process to follow in creating our sales expectations.” My friend Steve Carbonara has been selling software to healthcare enterprises for years so I asked him to write a companion to his piece on selling to hospitals. Steve is currently the Chief Sales Officer at Cohealo, Inc.

HIMSS13 debrief podcast with Gregg Masters, John Lynn, and Dr. Pat Salber

Sun, 05 May 2013 15:54:45 +0000

Following HiMSS13 in New Orleans I sat down last month in a BlogTalkRadio broadcast with Dr. Pat Salber (@DocWeighsIn @HealthTechHatch), Gregg Masters (@2healthguru @ACOwatch) and John Lynn (@techguy) with a ‘debrief’ of our key HIMSS13 take-aways as well as our latest venture, Influential Networks. I covered the following topics in the podcast: The HIMSS 13 cheerleading and “echo chamber” Are we moving faster with MU than the industry can really accomodate?

Reducing Shadow IT in healthcare by embracing “good enough for HIPAA” business-friendly SaaS tools

Sun, 05 May 2013 14:29:11 +0000

I’ve said repeatedly that any cloud / SaaS vendor that wants to be taken seriously in healthcare must be willing to sign a HIPAA Business Associate Agreement (BAA) and I was happy to hear that Box.com is now willing to do so. I’m quite pleased that we’re finally seeing some serious healthcare SaaS offerings from horizontal (non-healthcare-specific) vendors. Only when we move beyond healthcare-specific offerings will we be able to unshackle ourselves from the decades old legacy health IT vendors and that’s great news.

What’s Next for Healthcare Information Technology Innovation

Sun, 05 May 2013 00:26:36 +0000

Last week the Greater Chicago Chapter of HIMSS invited me to participate in their healthcare technology webinar series. I covered the topic “What’s Next for Healthcare Information Technology Innovation?” and the screencast with audio has been posted here. I covered numerous topics that are helpful for entrepreneurs and engineers that want to create innovative healthcare technology.

Guest Article: Crawl, walk, and then run towards analytics and big data in healthcare

Sun, 14 Apr 2013 00:44:55 +0000

I posted an article recently concerning the need to be more practical in the use of data vs. the need to go after the latest buzzwords, i.e. Big Data. Dan Reber posted a great comment on the article that I found enlightening so I reached out to him to expand on his thinking. Dan is in charge of product strategy at Origin Healthcare Solutions for their Business and Clinical Intelligence application (Precision.

Guest Article: How to use WebID to create Single Sign On (SSO) across Healthcare Systems

Sun, 14 Apr 2013 00:25:23 +0000

I have been speaking and writing often these days about how single sign on (SSO) technologies are probably one of the most important components of health IT data integration. To help figure out how to integrate multiple systems using standards-based SSO approaches I reached out to Shahid Qadri, a Data Scientist and Software Developer for Applied informatics Inc. Qadri works on health data integration and semantic web and when I heard that he created a solution (which won second place) for an ONC single sign on challenge I thought he’d be the perfect engineer to help the rest of us.

Protect yourself from Shadow IT, embrace “good enough for HIPAA” secure cloud services like Box and Skydrive

Tue, 09 Apr 2013 01:28:21 +0000

It’s a common misconception that if executives at hospitals or practices don’t have time to deliver sophisticated IT solutions to their users that users will just wait patiently and hope that solutions will arrive someday. However, there is a larger Shadow IT movement in many clinical settings than senior executives are willing to admit. Given the wealth of cloud offerings available, many of which have better security in the cloud than some on-premises “clinical” solutions, Shadow IT is growing and will cause more problems in the future as we try to reign it in.

Guest Article: Try not to fall for the Big Data in Healthcare hype, focus on actionable data that can improve clinical workflows

Mon, 25 Feb 2013 14:39:16 +0000

Many readers write to me regularly to ask what I think about “Big Data” in healthcare. I tell them that Big Data in our field is generally more hype than reality right now but that there’s a lot of promise and opportunity. To help elaborate on why this might be the case I’ve asked my friend Naeem Hashmi, Chief Research Officer at Information Frameworks, to give us his thoughts. Naeem has written a number of books on the subject of informatics and analytics and been on the front lines of engineering large scale healthcare systems to generate data for clinical analytical purposes.

Guest Article: How to test health IT interoperability

Mon, 25 Feb 2013 02:20:31 +0000

One of the key tenets of both the HITECH and Affordable Care Acts has been to drive improved patient care and reduction in cost by applying technology across all healthcare entities. A bigger challenge is how do to make multiple technology purchases interoperate within a provider network and / or across provider networks. There are solutions out there that can make it happen, but to make sure interoperability happens consistently, testing technology integration touch points is crucial but not easy without the right test infrastructure.

A few tips for those just getting started with content sharing and blogging

Sun, 17 Feb 2013 21:09:18 +0000

The popularity of blogs has been a given for years now but now that experienced professionals have tools like LinkedIn Groups, Google+, and even Facebook I often get asked for tips on what kind of content/information is “best” to be shared. I don’t know that I have any definitive answers but here are some suggestions based on the kinds of content I share with my readers: Focus on actionable advice and talk to people as if they’re smart enough to act on what you’re suggesting.

How to differentiate your health IT product and services, another webinar next week

Fri, 25 Jan 2013 01:02:37 +0000

John Lynn and I teamed up with Cari McLean (@carimclean) and Michael Gaspar (@MichaelGaspar) from the HIMSS Social Media team to talk about how to differentiate your products and services at the HIMSS 2013 Conference. Cari and Michael are two social media experts and were a joy to work with. We were humbled that they invited us to help HIMSS Exhibitors understand how best to use social media to get the most out of their 2013 Conference investment.

Just because we have apps for smartphones doesn’t mean we have real mobility in healthcare

Fri, 21 Dec 2012 12:46:47 +0000

__App47 CEO and co-founder** Chris Schroeder** hosts a great podcast series called __“What’s Appening!” in which he covers topics around enterprise-grade Mobile Application Management for securely deploying, managing, and analyzing business-critical mobile apps. Chris interviewed me for a recent episode__ in which we spoke at length about the management of enterprise healthcare apps, what mobility means in healthcare, and why technically-savvy clinicians are the only real salvation for the healthcare IT industry.

Leveraging digital signage for more than patient education and marketing – real service improvement

Thu, 20 Dec 2012 20:20:53 +0000

Earlier in the week I was in a waiting room for a physician visit and as I sat there for much longer than I wanted, I kept wondering “what patient number am I and how many people will be seen before me?” Given that we are in the trailing days of the year 2012 with some significantly advanced technology at our fingertips it bothered me even more that there was no way to know what was going on without asking the front desk receptionist every 5 minutes.

What’s next for healthcare information technology innovation?

Mon, 19 Nov 2012 01:06:40 +0000

In Nashville on Friday, at the Vanderbilt Healthcare Conference, I gave a short talk on a panel focused on the question “What’s next for healthcare information technology innovation?” The talk focused on answering a couple of key questions: What does innovation in healthcare mean? Where are the major areas in healthcare where innovation is required? And it had a few key takeaways: Understand health tech buyer fallacies Understand PBU: Payer vs.

‘Practical Data’, ‘Actionable Data’ and ‘Useful Data’ vs. ‘Big Data’ in healthcare and medical devices sector

Mon, 12 Nov 2012 00:03:58 +0000

Having recently spoken at about a half dozen conferences on the subject of big data in government and healthcare I’ve come to the conclusion that we’re focusing, at least in healthcare, on the wrong topic. When we’re dealing with individual patients, and even population health across multiple patients, the size and velocity of the data (“big data”) isn’t anywhere near as important as “actionable data” or “useful data” – by focusing on, and frankly scaring people with, the term “big data” we’re undermining the potential immediate utility of all kinds of “small data”.

Do’s and Dont’s for effective “lightening” demos of your health IT product

Wed, 24 Oct 2012 11:25:58 +0000

I’ll be moderating the the first of 3 “Innovator’s Challenge” sessions at the Partners 2012 Connected Health Symposium & Expo. It’s not easy for a company to be selected for a prestigious demo session like this and if the demos are done right they can help the company gain traction in the market. The Innovator’s Challenge sessions use the “lightening” format where each participant has 5 or fewer minutes to do their demo before the next one starts (barely 30 seconds of transition between demos).

Essentials of telehealth and telemedicine, top Do’s and Don’ts, mHealth and other health IT advice

Thu, 11 Oct 2012 20:17:22 +0000

I recently participated in a wonderful 55 minute video interview conducted by Nirav Desai for his_ **Hands On TeleHealth Interview **show_. I wanted to thank Nirav for leading an insightful discussion; you can watch the video on Nirav’s site but I wanted to capture the essence of the interview in the transcription below. Nirav: What are the essentials of Telehealth and Telemedicine? Shahid: Telehealth and Telemedicine are about extending health care from physical institutions, where it has most recently resided, to where the patients can receive care at home or other more convenient locations.

Join me in Boston on Nov 1st and 2nd to learn about how to build health IT cloud agents and med device gateways

Thu, 04 Oct 2012 00:05:27 +0000

I’ve been invited back to speak at the Fourth Annual Medical Device Connectivity Conference (MDCC), one of the best practical and “get the job done” kind conferences that I attend all year. I’ll be talking on a panel, giving a short lecture, and doing another workshop. If you haven’t signed up for MDCC yes, please jump on over to their website and register. This is one of my favorite events of the year because it’s a “doers” (not just a “thinkers”) conference :-).

How do you decide which features to add to your software?

Wed, 26 Sep 2012 00:50:30 +0000

Given the well-warranted focus on design these days it’s always difficult to find the right balance between features that we should add to our software and those that we leave out. I was running a class recently on how to build product roadmaps for health IT apps / medical device software and the question of how we should decide which features to add came up. Here’s are just a few of the facets I talked about during that lecture:

Should you partner with another technology / services company to help sell your product?

Tue, 18 Sep 2012 20:00:39 +0000

Over the last few weeks a number of clients and readers have asked a similar question: I’ve been approached by company X to partner with us. Do you know them and what do you think we should do? Since many startups, especially technology firms, partner for the wrong reasons and end up having failed or suboptimal relationships I thought I’d give as simple an answer as possible for partnering.

First wave of MU Stage 2 (2014 Edition) Draft Test Procedures Released

Sun, 09 Sep 2012 14:48:11 +0000

If you’re in charge of getting your software ready for MU Stage 2, please be sure to keep a regular eye on the 2014 Edition Draft Test Procedures page on the ONC site. Here’s the overview: The Office of the National Coordinator for Health Information Technology (ONC) has posted the first wave of draft Test Procedures and applicable test data files for the 2014 Edition EHR certification criteria. The Test Procedures, once finalized and approved by the National Coordinator, will be used for testing and certifying EHR technology under the ONC HIT Certification Program (formerly referred to as the Permanent Certification Program or PCP).

Guest Article: 8 Mistakes to Avoid when Securing Cloud Services

Thu, 26 Jul 2012 16:28:04 +0000

There’s solid demand these days for services like DropBox.com or Box.net that allow easy but secure file sharing to occur with proper privacy restrictions and audit tracking. I was pleasantly surprised to learn that there are a few companies, such as FolderGrid, trying to solve the problem of HIPAA-compliant file sharing. What FolderGrid is doing, though, is quite unique in healthcare – creating infrastructure software for other health IT developers to build on top of.

NIST’s Guide to Rating Software Vulnerabilities from Misuse might be helpful for health IT security

Wed, 25 Jul 2012 22:08:43 +0000

A new NIST new guide The Common Misuse Scoring System (CMSS): Metrics for Software Feature Misuse Vulnerabilities, (NISTIR 7864) is available for download. In the health IT and medical device security world we’re often wondering how to classify vulnerabilities so that we can appropriately prioritize them and ensure they get corrected. Here’s how NIST describes their new guide (copied from their website, emphasis is mine): A new guide from the National Institute of Standards and Technology (NIST) describes a “scoring system” that computer security managers can use to assess the severity of security risks arising from software features that, while beneficial to accomplishing a task, are at least partially designed under an assumption that users are operating these features as intended.

Telehealth means better care for patients and a new business opportunity for care delivery organizations

Wed, 18 Jul 2012 11:54:14 +0000

The fiscal challenges confronting the healthcare industry around the world requires shifting the delivery of care from expensive centralized settings to lower cost settings while seeking to improve quality and patient experience. Organizations such as hospitals, Integrated Delivery Networks (IDNs) and newly created Accountable Care Organizations (ACOs) are trying to find the right mix of technology, facilities, clinical personnel, and information sharing to address these issues. Telehealth and “connected care” experiments have shown that many types of expensive care that had been, in the past, reserved for office visits or hospital attendance can easily be done in the home or a lower cost setting.

Guest Article: 5 more PACS interconnectivity and interoperability issues and their solutions

Mon, 16 Jul 2012 00:45:36 +0000

Most health IT interoperability and connectivity discussions these days center around HL7, CCD, and other structured data interchange. However, the vast majority of data (in terms of size) is shared as images and documents. The DICOM and PACS standards are very successful but given the number of questions I get about them from readers it seems there’s still a lot of guidance and support needed. To help answer some of the most common technical questions, I reached out to a fellow health IT expert, Herman Oosterwijk from OTech.

Guest Article: Top 10 Things Hospitals Should Do to Achieve Hard-Dollar ROI with their RTLS Asset Management Solution

Fri, 06 Jul 2012 02:10:23 +0000

There are very few “no brainers” in hospital technology purchases – most of the decisions about what to buy and how to implement what we buy are complex. However, one decision is pretty easy – you have to put in asset management and tracking solutions for obvious reasons. But, how do you make sure that you can achieve a meaningful ROI on your purchase? I reached out to Marcus Ruark, Vice President at Intelligent InSites, and a seasoned technology executive with a deep understanding of healthcare operations and business processes to help answer that question.

Join me at Healthcare Unbound in San Francisco on July 19, 20 to discuss health IT platforms and big data in healthcare

Thu, 05 Jul 2012 12:12:39 +0000

I’ve been invited to speak at Healthcare Unbound (HU), one of the earliest conferences to focus on “connected health”. HU is in its 9th year of promoting the now well accepted ideas of connected health and it’s got a great speaker lineup as well as a terrific audience makeup. If you’ll be at conference or are in the San Francisco area and would like to meetup at or near the event, please reach out to me via speaking@shahidshah.

Guest Article: Top 5 PACS interconnectivity and interoperability issues and their solutions

Fri, 22 Jun 2012 10:43:16 +0000

What healthcare can learn from the new Department of Defense (DoD) Mobility Device Strategy

Sun, 17 Jun 2012 14:54:16 +0000

The Department of Defense (DoD) recently released their mobile device strategy that talks about how to enable the use of mobile devices in defense applications. The DoD ‘s requirements around security and reliability for mobile apps and devices are just as stringent as those that should be implemented in healthcare so there’s probably a lot for CIOs and CTOs to take from it. The DoD Mobile Device Strategy focuses on “improving three areas critical to mobility: wireless infrastructure, mobile devices, and mobile applications, and works to ensure these areas remain reliable, secure and flexible enough to keep up with fast-changing technology.

Check out these videos if you’re looking for healthcare IT jobs

Sun, 17 Jun 2012 01:43:40 +0000

The nice folks at HealthAdministrationDegrees.com recently interviewed me about my thoughts on healthcare IT and how to get jobs in the industry. The following questions came up: How did you get started blogging, and what was the goal behind your blog the Healthcare IT Guy? How can someone get started working in healthcare IT? How important is it to have a medical or healthcare background in addition to an IT background?

How to design next-generation EHR data models

Mon, 04 Jun 2012 14:20:46 +0000

Today’s reality of patient management is “disjointed care” and most of the collaborators in a patient’s care team don’t know what each other is doing for the patient in real time. Knowing all the different participants in the patient’s care team (providers, payers, family members, etc.) and coordinating and integrating their electronic activities is what successful EHRs must handle with ease as they look to graduate from basic retrospective documentation systems to modern patient collaboration platforms.

Join me on June 2 in Baltimore to hear me speak about mHealth, cloud, wireless life sciences, patient access to EHRs, and Connected Medical Devices

Tue, 22 May 2012 11:02:33 +0000

The Baltimore Chapter of the IEEE Engineering in Medicine and Biology Society (EMBS) has invited me to come and talk about mobile health, cloud, wireless life sciences, patient centered access to their electronic records, and connected medical devices. I will be presenting and moderating discussions on Saturday, June 2 at the National Electronics Museum in Linthicum, Maryland. You don’t need to be an IEEE member and guests are welcome to attend – please register here for the free event.

Guest Article: In a world of cloud services, are HL7 interface engines dead?

Tue, 08 May 2012 10:57:03 +0000

I spend a good deal of time with clients these days who are trying to connect web services, implement service oriented architecture (SOA), and moving to the cloud. All these requirements are focused on integration of multiple, sometimes legacy sometimes modern, systems but most of them still require lots of HL7 interfacing. Some of my clients start their integration efforts hoping that there is something better or more modern than HL7 but the truth is that HL7 and interfacing remains the backbone of health system integration.

What I learned at the HIMSS Conference about developments in Health IT for the rest of 2012

Tue, 27 Mar 2012 10:30:55 +0000

Like many of you, I made the annual pilgrimage to the HIMSS Conference last month; here’s what I learned while I was in Vegas and my takeaways for the rest of the year. Major developments in Health IT for the rest of 2012 It was discussed a lot in the educational sessions and vendors didn’t talk about it much, but the new realities of complex business models (like PCMH and ACOs) mean that standardization of clinical workflows won’t really be possible for a while.

Take new practice management technologies to the bank as patients push for online services

Mon, 26 Mar 2012 00:16:38 +0000

I was recently interviewed for a nice article on why and how private physician practices should push for new technologies. Andrea Downing Peck did a pretty good job putting together a collage of views from me and some of my well known colleagues online: Mary Pat Whaley, David Henriksen, Dr. Jaan Sidorov, Shari Crooker, Rosemarie Nelson, David Harvey, David Williams. Here are some of my favorite quotes (taken directly from the article):

Join me on Friday afternoon for the Military EHR Conference in Arlington, VA

Wed, 14 Mar 2012 11:01:58 +0000

The Military Electronic Health Records Conference is being held at the Holiday Inn Rosslyn in Arlington, VA on Thursday and Friday this week. Military EHRs are a complicated topic and I have been invited to deliver a talk called Using Connected Medical Devices to Improve Military EHRs & Integrating Social Media into Military EHRs. I will be presenting on Friday afternoon at 1:45p but should be around at the conference before and after as well if you’d like to meetup.

Guest Article: Do’s and Dont’s of RFID in Hospitals

Sun, 04 Mar 2012 16:20:50 +0000

I’ve written and presented recently on a number of “Do’s and Dont’s” around medical device integration, mobile health, EHRs, and various related topics. Some of you have asked if I could do something similar on the subject of RFID. Since I’m not an expert on the topic, I reached out to Yedidia Blonder, a Product Manager at Vizbee RFID Solutions. Vizbee offers RFID applications for multiple industries, including a patient and hospital asset tracking application for healthcare institutions.

Meaningful Use Stage 2 NPRM means new opportunities for Medical Device and non-traditional Health IT Vendors

Sun, 04 Mar 2012 16:05:25 +0000

Last week at the HIMSS Conference ONC announced Meaningful Use Stage 2 Notice of Proposed Rule-Making. Many of you have asked me for a quick opinion of what it means to health IT and medical device vendors so I wanted to take a few minutes to share my initial thoughts. Meaningful Use Stage 1 was mostly about setting the bare minimum electronic health record functional requirements and pegging a “floor” for data capture; it had many required elements a few optional elements for care providers to utilize (but vendors had to make even the optional functionality available for use).

Tips from Real Users on How to Succeed with Electronic Medical Records

Sun, 19 Feb 2012 14:12:35 +0000

There are important differences between the health care providers who truly reap the benefits of switching to EMR, and those who don’t. I’ve covered some of these differences before and I was pleased to see that Katie Matlack, Medical Analyst at Software Advice, actually went a step further and interviewed representatives of three health providers using EMRs now, identifying some key takeaways to extend the conversation. Below are four tips, and for the other four tips, you can view the entire article on her blog.

Guest Article: Techniques for matching patient record data across disparate EHRs and other systems

Thu, 09 Feb 2012 04:04:32 +0000

Some of the most frequent questions I receive these days surround data interoperability and integrating multiple health IT systems. One of the biggest problems in connectivity is matching patient record data and ensuring that the same patient data in different systems is linked properly. Given how many times this topic comes up, I reached out to Cameron Thompson, Acxiom Healthcare Group Managing Director. Acxiom has an interesting method of patient data matching, called persistent links, and when I saw what they were doing for matching consumer records in non-healthcare settings (e.

Join me in San Francisco on Monday where I’m talking about Using Android in Safety-Critical Medical Device Platforms

Thu, 09 Feb 2012 03:20:53 +0000

The Linux Foundation has invited me to speak about how to use Android in Medical Devices on Monday, February 14 at the Android Builders Summit. If you’ll be at the Summit or are in the San Francisco area and would like to meetup at or near the event, please reach out to me via speaking@shahidshah.com. Here’s the abstract of my talk on Monday: FDA regulated medical devices are considered safety-critical systems due to their ability to affect patient lives.

I’m speaking at NIH Clinical Center on Why Meaningful Use (MU) and EHRs are Insufficient for Evidence Based Medicine (EBM) and Comparative Effectiveness Research (CER)

Wed, 08 Feb 2012 13:18:09 +0000

If you’re in the DC area near NIH please join me tomorrow as I lead a discussion on why MU is insufficient for EBM and CER. Here are the details: When****: 3:30 – 5:00 PM, Thursday, February 9, 2012 Where****: NIH Clinical Center (Building 10 North), Hatfield Room 2-3330 Abstract****: Comparative Effectiveness Research (CER), which is being rechristened “Patient-Centered Outcomes Research” (PCOR), is all about using clinical outcomes research comparing different interventions and strategies to prevent, diagnose, treat and monitor health conditions.

Do’s and Don’ts of Telemedicine

Tue, 17 Jan 2012 13:00:21 +0000

This is the next post in my series of Do’s and Don’ts Healthcare IT. As we all know, some of our most important citizens live in rural settings, small cities, the countryside, or remote areas. These areas have smaller populations and less direct access to vital healthcare resources. In the past 15 years or so we’ve made some great strides in remotely accessible healthcare; these offerings, called telemedical tools, provide important clinical care at a distance.

Do’s and Don’ts of mobile/mHealth strategy for hospitals and HCPs

Fri, 13 Jan 2012 12:39:24 +0000

I recently wrote, in Do’s and Don’ts of hospital health IT, that you shouldn’t make long-term decisions on mobile app platforms like iOS and Android because the mobile world is still quite young and the war between Apple, Microsoft, and Google is nowhere near being resolved. A couple of readers, in the comments section (thanks Anne and DDS), asked me to elaborate mobile and mHealth strategy for healthcare professionals (HCPs) and hospitals.

MU attestation vendor data available for analysis

Tue, 10 Jan 2012 11:45:00 +0000

In case you haven’t seen it, MU attestations data is now available on Data.gov and it includes analyzable vendor statistics. The data set merges information about the Centers for Medicare and Medicaid Services, Medicare and Medicaid EHR Incentive Programs attestations with the Office of the National Coordinator for Health IT, Certified Health IT Products List. This new dataset enables systematic analysis of the distribution of certified EHR vendors and products among those providers that have attested to meaningful use within the CMS EHR Incentive Programs.

Do’s and Don’ts of hospital health IT

Mon, 09 Jan 2012 02:01:42 +0000

Last year I started a series of “Do’s and Dont’s” in hospital tech by focusing on wireless technologies. Folks asked a lot of questions about do’s and dont’s in other tech areas so here’s a list of more tips and tricks: Do start implementing cloud-based services. Don’t think, though, that just because you are implementing cloud services that you will have less infrastructure or related work to do. Cloud services, especially in the SaaS realm, are “application-centric” solutions and as such the infrastructure requirements remain pretty substantial – especially the sophistication of the network infrastructure.

Preparing for EHR implementation with the AHRQ Health IT Toolkit for Workflow Assessment

Mon, 02 Jan 2012 15:57:19 +0000

One of the most important activities you can undertake before you begin your EHR implementation journey is to standardize and simplify your processes to help prepare for automation. Unlike humans, which can handle diversity, computers hate variations. Before you begin your software selection process, get help from a practice consultant to reduce the number of appointment types you manage, reduce the number of different forms you use, ensure that your charting categories (“Labs”, “Notes”, etc.

Healthcare Cloud definitions should be based on NIST’s definitions

Sat, 24 Dec 2011 13:59:12 +0000

As most of my regular readers know, I work as a technology strategy advisor for several different government agencies; in that role I get to spend quality time with folks from NIST (the National Institute of Standards and Technology), what I consider one of the government’s most prominent think tanks. They’re doing yeoman’s work trying to get the massive federal government’s different agencies working in common directions and the technology folks I’ve met seem cognizant of the influence (good and bad) they have; they seem to try to wield that power as carefully as they know how.

To make physicians more productive, focus on IT and tools for their supporting staff first

Wed, 21 Dec 2011 13:36:23 +0000

Productivity loss and workflow disruptions are commonplace as our industry gets on the Meaningful Use bandwagon and is starting to adopt EHR systems at a slightly more rapid pace than in previous years (things aren’t really as rosy as many think, but the pace is picking up). The reason we have productivity loss is that we focus changing the behaviors of our most expensive resources too early in our automation journeys – we go after doctors first.

Video of my debate with Connected Health’s Dr. Kvedar on quality improvement using patient self-management techniques

Fri, 09 Dec 2011 22:39:48 +0000

Earlier this year, when I traveled to Denmark to review some of their Health IT companies, I spent a couple of days with Joe Ternullo of Partners Healthcare and their Center for Connected Health. Joe is a gentleman in the classic sense of the word and one of the nicest people you’ll ever meet; I was amazed at how connected he was to outcomes-driven health IT and quite impressed with his knowledge of the industry.

Join me for my EHR usability webinar on November 30 at 1:00p

Mon, 14 Nov 2011 02:38:15 +0000

I met researchers from Macadamian, a global UI design and innovation studio that has been doing some great work in the health IT usability space, at the recent EHR Usability Symposium held at NIST a couple of months ago. I was immediately impressed by their work so when they asked me to work with them on presenting NIST’s new Usability Criteria for Health IT and EHR Software document, I welcomed the opportunity.

Guest Article: Policy management software for hospitals and clinics helps with change management

Mon, 31 Oct 2011 00:58:31 +0000

Complex healthcare IT projects like EHR implementations, ICD-10 migration, and related IT initiatives require sophisticated change management practices and policies. Given the people-centric nature of policy development, those of us in IT usually assume that change and policy management can’t be automated, usually to our detriment. To help understand how that’s not quite correct, I reached out to the developers of PolicyStat, which provides policy and procedure software for hospitals, labs, outpatient clinics and integrated health networks.

Guest Article: Actionable advice on how to make tangible progress in ICD-9 to ICD-10 migration

Mon, 17 Oct 2011 19:40:58 +0000

The CMS-required ICD-9 to ICD-10 migration requirement is creeping upon us and I’ve been getting lots of questions from readers about what steps technology vendors and healthcare providers should be taking in getting ready for the undertaking. To help get some actionable advice I reached out to Steve Dion, a senior marketing manager for GE Healthcare, and Kim Lorusso a product marketing manager for GE Healthcare. They have been successful in helping many customers make progress on their ICD-10 migration by using GE’s Centricity Business solution for ICD-10; it is something worth checking out and you can follow them on Twitter at @GEHealthcareIT.

How to manage HIPAA security in a way that actually enhances security and not just fills in documentation

Sun, 18 Sep 2011 20:59:20 +0000

I get lots of questions about HIPAA security these days; especially as EHR firms, hospitals, payers, and startups alike are being asked about their HIPAA policies. My general recommendation is that you should forget about HIPAA at first (it’s a toothless, generally unenforceable, regulation that will never improve security because it is a bureaucratic compliance tool). Instead, you should concentrate on good security practices, good security policies, follow recommended NIST guidance, and then come back and tie in the HIPAA regulations to make sure you don’t miss anything from the privacy side.

Health Wonk Review up at Health Business Blog

Sun, 18 Sep 2011 19:13:56 +0000

David E. Williams, a very smart strategy consultant in technology enabled health care services, pharma, biotech, and medical devices has posted his edition of the Health Wonk Review. It’s pithy and worth checking out.

Regulatory compliance officers need not fear open source software in medical devices or mission-critical healthcare IT systems

Mon, 12 Sep 2011 00:37:48 +0000

I spent the past few days in Boston at the Harvard Medical School Conference Center speaking audiences at the Medical Device Connectivity Conference (I presented lectures on how to design next-generation medical devices and gateways). Many people that attended my lectures showed a great deal of trepidation when I brought up the fact that they should use open source software (OSS) to reduce cost and potentially increase the quality of their devices; the most common excuse I heard was that the regulatory compliance folks wouldn’t allow OSS or that the FDA would disapprove.

The realities of getting a job in healthcare IT

Sun, 11 Sep 2011 22:19:00 +0000

A few weeks ago I was interviewed by Diann Daniel for an article she recently posted about healthcare IT careers. It’s worth checking out if you’re looking to enter the health IT field. Here was my advice during the interview: Hiring managers are making a mistake if they aren’t looking outside of healthcare for filling IT roles. The only roles that can not be filled by outsiders are in clinical engineering and application-specific specialists.

Using open source software in safety-critical medical devices

Sun, 04 Sep 2011 12:01:08 +0000

Earlier this year the nice folks at O’Reilly Associates were kind enough to invite me to speak about how to use open source in safety-critical medical devices. The open source conference (“OSCon 2011”) was terrific and I met some old friends as well as made tons of new friends. Many of you have asked me to upload my presentation from the talk and I’m happy to oblige. As we know, FDA regulated medical devices are considered safety-critical systems due to their ability to affect patient lives.

Denmark has lots of healthcare IT competence and a potentially formidable talent pool

Sun, 04 Sep 2011 11:37:27 +0000

Many people outside our country believe that we’re “behind the times” when it comes to healthcare IT. So, over the past few years I’ve traveled to several countries, usually at the request of embassies, to help evaluate various technical / IT companies to see how much applicability they have to the U.S. government or healthcare markets (both specialties of mine). I typically go out, speak at conferences, conduct my reviews, and end up coming back with only a few companies or pockets of interesting projects that might find some success selling to the U.

$50k available for your health IT startup ideas

Fri, 02 Sep 2011 14:22:00 +0000

This morning I spoke with the founders of HealthBox, a business incubator and accelerator program focused on health IT startups. If you’ve got a great idea that you’d like to get funded, need $50k to make it come to fruition, and don’t mind giving up 7% of your company to the accelerator program then HealthBox may be for you. They’re giving away a good amount of cash ($50k vs. the normal $20k for other tech accelerators), but what I like most about their effort is that they have a strong partnership with three key buyer segments: Walgreens for retail, Ridgeview Medical Center for providers, and Blue Cross Blue Shield for payers.

Join me in Boston on Sept 8th and 9th to learn about how to build health IT and med device gateways

Wed, 24 Aug 2011 02:51:24 +0000

I’ve been invited back to speak at the Medical Device Connectivity Conference, one of the best practical and “get the job done” kind conferences that I attend all year. This year I am Chairing the “Manufacturers” track, participating in one panel, and giving two talks – my short talk is a presentation entitled “Best Practices for Embedded Medical Device and Gateway Software Applications” and the other is a longer workshop called “How to use Open Source Software and other Low-Cost Design Techniques To Build Safety-Critical Medical Device Platforms and Meaningful Use EHR Gateways”.

How to get a job in healthcare IT when you don’t have specific experience

Sun, 07 Aug 2011 11:33:21 +0000

I get questions from students and career changers who want to enter the healthcare IT field routinely and I enjoy replying privately to help out where I can. One question I received a few days ago is especially common so I thought I’d provide an answer publicly: I am currently a student at [a healthcare IT training program]. This is a career change for me … my only medical experience is as a patient.

FDA’s new draft guidance on mobile apps and what it means to health IT vendors

Fri, 22 Jul 2011 01:50:04 +0000

The FDA released the (currently non-binding) “Draft Guidance for Industry and Food and Drug Administration Staff on Mobile Medical Applications” earlier this week. I knew many of my clients and readers would be asking about the ramifications of this new guidance so I read the document as soon as it came out. In general I was impressed by the FDA’s balanced approach to patient safety and their desire not to stifle competition; overall I thought they were not looking to overreach their purview and I think they succeeded (except for the part on clinical decision support, discussed further below).

How to teach Microsoft applications that “HER” is not the proper replacement for “EHR”

Fri, 22 Jul 2011 01:15:03 +0000

After the 4 thousandth time I’ve cursed Microsoft Outlook, Word, or Excel for “auto correcting” the acronym “EHR" to “HER” I finally took 30 seconds to fix this once and for all. I figured with 20 years of programming experience I should be able to figure it out 🙂 Here’s what you should do if you’re tired of having to change “HER” back to “EHR" in Microsoft Word, Excel, and other apps (I copied some of this from the Microsoft Help text):

Life Sciences venture investing dramatically outperformed Tech venture investing over the past decade

Mon, 11 Jul 2011 20:54:12 +0000

I read with great interest a study posted on TheBij.com which talks about venture investment returns in the healthcare field: Life Sciences: The Rodney Dangerfield of Venture Capital. I’ve been in the general IT as well as the specific healthcare IT world for many years but the study results managed to surprise me, specifically the following: A widely held notion … is that Life Sciences/ Healthcare (LS) venture investing is too challenging and has underperformed IT and Internet (Tech) investing over the past decade and will only continue to do so.

Why medical device data is the best way to fill meaningful use EHRs and conduct comparative effectiveness research (CER)

Mon, 11 Jul 2011 13:50:57 +0000

I will be presenting at the O’Reilly Open Source Convention (OSCon) in Portland at the end of the month. As an avid reader of dozens of O’Reilly’s technical books over the years I was excited when they reached out to ask if I would talk about open source in the healthcare world. While open source isn’t a major force in the healthcare IT ecosystem right now, that will be changing over the coming years and should be able to change the medical world in the same way that open source has improved enterprise IT and made the consumer web possible.

Now that Google Health is dead, what did we learn about PHRs? That engagement and messaging is what matters.

Fri, 24 Jun 2011 22:45:17 +0000

UPDATE: eWeek picked up this story and referenced it in their latest post on the subject. As I mentioned by way of the Wall Street Journal back at the end of March, Google Health was supposed to get less support under the new CEO. We learned today that “less support” meant that it would be retired on January 1, 2012 and eventually shut down on January 1, 2013. Basically this means that the grand experiment didn’t work out, but it was valiant and worthy try.

Guest Article: How to sell your EHR and other health IT products into clinics and physician practices

Thu, 16 Jun 2011 14:32:16 +0000

A frequent question I am asked by startups and new product development teams (especially those building EMRs / EHRs) is “what’s the best way to sell my EHR to doctors and clinics?” My friend Steve Carbonara has been selling software to practices for years so I asked him to write a companion to his piece on selling to hospitals. Steve currently heads Sales Force Effectiveness at Bard Medical and runs his own consulting practice helping companies with their sales process.

Report from NIST EHR Usability Forum: 5 Things EHR Vendors Should Do Right Now to Prepare for Meaningful Use Usability Criteria

Sun, 12 Jun 2011 14:39:43 +0000

_Last week I was invited to attend the second annual NIST forum for EHR Usability called “A Community-Building Workshop: Measuring, Evaluating and Improving the Usability of Electronic Health Records.” NIST, in collaboration with the ONC, unveiled its initial discussion points for what it might consider as the “Usability Criteria” in the upcoming Meaningful Use Stage 2 regulations. At the event I met with Dr. Melanie Rodney, Distinguished Researcher at Macadamian and a member of the HIMSS Usability task force; I was impressed by the work that she and her firm were doing in EHR usability space.

Guest Article: Smartphones aren’t the only patient communications devices, text messaging works better sometimes

Sat, 11 Jun 2011 01:02:42 +0000

With the mobile and tablet frenzy at a fevered pitch, most of us technical folks end up thinking that the best way to reach patients is through the most expensive means possible (a high end PC, a tablet, a smart phone, etc.) because those are the devices we’re using all the time, too. However, sometimes (maybe more often than not), simple text messaging to feature phones and smart phones may be the best option.

Transparent heath data and APIs are real, where were the med device vendors?

Thu, 09 Jun 2011 21:49:55 +0000

I was invited to attend the second annual Healthcare Data Initiative Forum at the NIH Institute of Medicine (IOM) and after spending most of the day today listening to the keynotes and panelists as well as acting as a judge for some of the app contests, I’m leaving impressed and full of hope for our little tech corner of the world. This “open data forum” or “data palooza” as it’s affectionately called was well attended — the gathering was kicked off by no less than Kathleen Sebelius (HHS Secretary), Francis Collins (NIH Director), and Todd Park (HHS CTO, who was energetic and terrific, as usual).

Health Wonk Review posted at The Health Care Blog

Thu, 09 Jun 2011 14:02:36 +0000

John Irvine and Matthew Holt have posted this week’s issue of Health Wonk Review at The Health Care Blog – lots of good reading. John and Matthew talk about the IOM Health Data Initiative Forum (called the “Data Palooza”) where I’m writing from today (I’m helping judge a contest on apps). Also covered is other health IT news, policy, media, and economics news. Check it out.

Guest Article: How to sell your health IT products into hospitals

Wed, 25 May 2011 15:14:13 +0000

One of the most frequent questions I am asked by startups and new product development teams is “what’s the best way to sell my X product into a hospital?” It’s a terrific question so I reached out to a friend of mine, Steve Carbonara, who heads Sales Force Effectiveness at Bard Medical and runs his own consulting practice helping companies with their sales process. After 8 years of corporate sales experience in the health care IT industry with Misys Healthcare and Allscripts, Steve moved into a private practice, starting a consulting firm.

Harvard Business Review talks about Misys Open Source Solutions

Tue, 24 May 2011 17:24:07 +0000

One of my favorite magazines, Harvard Business Review (HBR), in its latest June issue has an article called “The Ambidextrous CEO” that is worth reading because it highlights innovation in healthcare IT (with a good story from Misys), specifically around open source. Here’s a point they made that’s worth repeating: Our research suggests that firms thrive when senior teams embrace the tension between old and new and foster a state of constant creative conflict at the top.

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Sun, 15 May 2011 21:14:29 +0000

Submit a Guest Article

Sun, 15 May 2011 21:14:29 +0000

Want to submit a contributed article or post? We have several options for you to submit content for coverage: [E-mail the story to our Story Editor](mailto:stories+healthcareguy.com@netspective.media?subject=[Netspective%20Media] Story or Guest Article Submission Request) where they will evaluate the coverage Sign up for an account at “The Healthcare Guys” and prepare a story for that site, which welcomes many different kinds of contributed articles that this blog does not. Craft a high impact super insightful article for this blog at The Healthcare IT Guy Still want to submit a guest article at this blog instead of HealthcareGuys.

Guest Article: So You Want to be an ACO? Focus on the Critical Technical Tasks and IT Tools

Mon, 02 May 2011 14:54:41 +0000

Ever since the draft ACO regulations were released by CMS a few weeks ago, I’ve been getting lots of questions about how technical teams and CIOs should be engaged with the business side to figure out their implementation strategies (I love these questions, by the way, so keep them coming). To help clarify some important technical and implementation issues, I’ve invited Dr. Mark Segal, vice president of government and industry affairs at GE Healthcare IT, to share his thoughts on the topic.

Join me at WWHI’s “Discussion with the FDA” on April 28th at second Health Care Innovation Day (HCI-DC)

Wed, 13 Apr 2011 10:55:15 +0000

On April 28, the West Wireless Health Institute (WWHI) will host its second Health Care Innovation Day (HCI-DC). I found last year’s event, which was very well attended, very helpful. I think WWHI’s events are quite useful because they let you meet the government officials involved in setting policy and rules for our industry. More then ever, what we do in healthcare IT and medical device development is dependent on the government so understanding their role and knowing the officials is crucial.

Join me for my Public Sector State and Local Executives’ HIE webinar Wednesday, April 13

Wed, 06 Apr 2011 12:37:11 +0000

State and local CIOs have worked for many years to foster the exchange of data between medical providers, health insurance plans, and government agencies. Building out such health information exchange (HIE) networks has been a long, sometimes painful, journey because of complex technical and administrative challenges in implementing them. Join me for my talk on what you can learn from the public sector CIOs that have some success overcoming the technical and administrative hurdles to create scalable, flexible networks capable of leveraging the complex integration of healthcare data.

Look beyond traditional health IT tools for Accountable Care Organization (ACO) implementations

Mon, 04 Apr 2011 12:48:46 +0000

As you’re probably already aware, CMS has announced the Medicare Shared Savings Program for Accountable Care Organizations or ACOs. The new program is another incentive program, like Meaningful Use (MU), but unlike MU there are no penalties for not participating in the program. In my opinion the ACO program is far more lucrative and likely more disruptive than MU and likely to yield, if done right, more patient quality improvements than MU.

This week’s edition of Health Wonk Review is at the Healthcare Economist

Thu, 31 Mar 2011 13:11:08 +0000

Jason Shafrin is our host for this week’s edition of Opening Day Edition of Health Wonk Review at the Healthcare Economist. It’ a concise compendium of the best of the health IT and health policy blogs over the last two weeks. Check it out!

Join me for a free webinar on “Understanding the Escalating Data Challenges of Meaningful Use” on Thursday, April 7th

Mon, 28 Mar 2011 12:52:14 +0000

I’ve been doing a good deal of coaching and consulting on what Meaningful Use really means to technology professionals lately so I was pleased to accept an invitation by Informatica to lead a webinar on that subject for a data management audience. Data management professionals and the executives that they report to have now had enough time to learn how difficult meeting the escalating requirements for MU actually is; most are reporting that it’s been more work than they thought.

WSJ: Google Health might get less support under new CEO

Sat, 26 Mar 2011 14:19:49 +0000

Interesting news this morning from the Wall Street Journal: Some managers believe Mr. Page will eliminate or downgrade projects he doesn’t believe are worthwhile, freeing up employees to work on more important initiatives, these people said. One project expected to get less support is Google Health, which lets people store medical records and other health data on Google’s servers, said people familiar with the matter. The statement above comes from WSJ’s article “At Google, Page Aims to Clear Red Tape” in which the reporter, Amir Efrati, lays out the case that Larry Page (the CEO that will take over April 4) is looking to streamline Google to act a bit more like a startup than the 24,000 person behemoth that it is.

Speakers needed for Business Intelligence & Analytics for Healthcare Conference & Exhibition (July 11-12 in San Diego)

Mon, 21 Mar 2011 19:33:49 +0000

The Center for Business Innovation (TCBI), run by my friend Satish Kavirajan, is currently organizing the Business Intelligence & Analytics for Healthcare Conference & Exhibition: Managing Data to Drive Quality, Financial Performance & Accountable Care, to be held in San Diego on July 11-12, 2011. I’m an advisor for the conference, will be speaking on several topics, and will be co-chairing. Satish puts together some great conferences because he focuses on specific topics and gives plenty of time for networking and one-on-one learning plus some very decent deep-dive workshops.

Guest Article: Safe usage of social networking is a good prescription for patients

Sun, 13 Mar 2011 22:30:52 +0000

Patricia Walling, a graduate student who has both professional and volunteer experience in a hospital environment, reached out to me via e-mail recently about some of her ideas of how physicians can communicate with their patients through social networking. I liked her ideas and invited her to put together an guest posting on the subject. Most healthcare professionals are already busy doing a hundred things a day and connecting to patients via social networks is probably the last thing on their minds; however, if patients are online they may have no choice but to meet them on the sites they frequent.

Waiting until 2012 on attestation for Meaningful Use doesn’t mean you shouldn’t buy an EHR in 2011

Sun, 13 Mar 2011 02:01:09 +0000

In my previous posting I wrote “You will be better off waiting until FY 2012 on Meaningful Use.” I received a bunch of questions via e-mail about that so I thought I would clarify my recommendations. I agree, based on Protima Advani’s evidence cited at iHealthBeat, that waiting until 2012 for attestation (registration, etc.) for Meaningful Use makes more sense for almost everyone since there’s no reduction in the incentives, there’s more time to implement your processes and procedures, and lower risk of how fast you must move to stage 2.

You will be better off waiting until FY 2012 on Meaningful Use

Thu, 10 Mar 2011 21:51:35 +0000

Anthony Guerra pointed me to an article by Protima Advani at iHealthBeat which contains some very important advice about whether you should consider attesting to Meaningful Use (MU) and go for incentive money in 2011 or 2012. Here is what Protima writes (bold, emphasis mine). The registration process and reporting period for the meaningful use incentive program officially commenced on Jan. 3. More than 21,000 health care providers have registered to date and many more are ramping up efforts to meet meaningful use criteria and collect federal incentives in fiscal year 2011.

SMART: A Facebook-like platform for medical apps

Wed, 09 Mar 2011 23:58:13 +0000

Today, Wil Yu (Special Assistant, Innovations) over at ONC wrote about a new innovation challenge that is giving out money to developers who can create micro apps that run in the new SMART architecture containers. If you’re not familiar with SMART and want a technical introduction, head over to the SMART Wiki; if you just want a quick overview from the business side, check out the home page. I personally love the idea — it’s basically a medical apps centric version of the FaceBook platform.

HIPAA and HITECH security starts with secure operating systems, proxies, and databases (Sudo 1.8)

Mon, 07 Mar 2011 13:35:33 +0000

I spend a lot of time talking with CEOs, CIOs, and other senior executives about what HIPAA security and HITECH privacy policies really mean. I hear a lot of naive talk about how systems are secure because “we use SSL encryption” or “we’re secure because we have a firewall”. Anybody who’s been security and privacy work for more than a few months would know how false those statements are. Security (whether it’s for HIPAA, HITECH, or banks) starts with secure operating systems, databases, and other infrastructure elements like proxies and firewalls and the depth of security is really controlled by system admins.

What human capital does it take to develop healthcare IT and EHR apps?

Sun, 06 Mar 2011 22:21:00 +0000

With tons of money coming into the healthcare IT ecosystem, it’s become vogue to build healthcare IT and EHR applications. When an engineer new to healthcare looks at a typical health application they think they can throw something quickly and sometimes bad advice is being given to business people who are budgeting for new projects. I’m often asked “What human capital does it take to develop healthcare IT and EHR apps?

If you’re serious about health IT or Med Tech implementations, consider attending IEEE International Symposium on Computer-Based Medical Systems

Sat, 05 Mar 2011 13:12:53 +0000

There are lots of conferences that take place in the USA and around the world on healthcare IT and medical device ecosystems — terrific gatherings like HIMSS and various other venues that cater to more about “what” you should be doing and not “how” to do the best implementations. If you’re a practitioner, engineer, project leader, or someone who’s responsible for actually creating software or hardware in the medical domain you’ll want to consider attending the IEEE International Symposium on Computer-Based Medical Systems in Bristol England June 27 through 30.

Is speech enabling your clinical app or EHR in a day really possible?

Fri, 04 Mar 2011 21:40:01 +0000

I spoke at length today with the nice folks from Nuance Healthcare and John Vasicek, Senior Engineering Director, sold me on their new Speech SDK (software development kit). Called “Speech Anywhere,” the SDK is part of the new Nuance Healthcare Development Platform which will hit the street by the end of the month. I’ve been a long-time user of Dragon Naturally Speaking and I’m continuously amazed as to how much better their recognition is for medical / clinical speech vs.

What can cause medical device and health IT projects go from “best case” to “worst case”

Fri, 04 Mar 2011 20:49:16 +0000

We always go into our medical device and healthcare IT projects with the best of intentions and the grandest of hopes. However, these are complex undertakings with patient safety and mission critical statuses in all but the most trivial cases. If you’re leading or participating in these projects you’ll be asked for launch estimates — I recommend that you never give one answer. Try and give a “best case” (where everything goes right), “nominal case” (the likely scenario), and “worst case” (where lots of mistakes are made).

Consider MySQL ‘Archive’ storage engine to store large amounts of med device structured or waveform data

Thu, 03 Mar 2011 16:47:29 +0000

I’ve been working on med device integrations for the many years now and one of the most common questions that arises when doing those integrations is “what’s the best way to save sensor waveform and analog to digital values?” Given the complexity of medical devices, there’s no single or simple answer but one approach that’s worked well for me in the past is to assume that whatever the data is, when it comes into digital format, it’s likely structured in some manner.

How to leverage Web 2.0 through content management systems for hospitals and practice websites

Wed, 02 Mar 2011 12:38:03 +0000

Most hospitals today have static (basic content) websites and many physician practices are putting up a static web presence as well. The more sophisticated health systems and practices, though, are building their sites on dynamic platforms that allow Web 2.0 functionality like social networking and online communities. IBM developerWorks recently asked me to talk about this trend so I wrote an article on how to develop content management systems for hospitals and leverage social Web 2.

How to develop lightweight ancillary tools connected to electronic health records systems

Wed, 02 Mar 2011 00:21:39 +0000

We’re already familiar with the HITECH Act and how it offers money to physicians, hospitals, and multi-hospital systems to become “meaningful users” of certified electronic health records (EHR) systems. Since most hospitals and large providers who are going after stimulus money will need to install an EHR, it’s important to choose one that allows great integration so that the investment can be realized for many years to come. Because most EHR vendors are focused on their own specific certification requirements (and not your specific enterprise needs), it’s important to have a strategy for how to extend EHR systems.

The Case for Regulating EMRs and the New FDA MDDS Rules

Fri, 18 Feb 2011 03:12:09 +0000

My friend Tim Gee has two great posts covering a couple of very important and timely topics. If you haven’t seen them, check out the following: The Case for Regulating EMRs In this article, Tim articulated the following: In testimony at the Health and Human Services’ Health Information Technology Policy Committee, Adoption/Certification Workshop held on February 25, 2010, CDRH Director, Jeffrey Shuren, gently articulated FDA’s intent to regulate EMR applications.

It’s HL7: What Can Go Wrong?

Wed, 12 Jan 2011 00:51:41 +0000

These days I’m getting lots of questions about medical connectivity, health data integration, and system interfaces. There are many options for custom clinical data integration but the best is of course HL7 because it’s ubiquitous. People that aren’t experienced with health data interfaces often think that since we have HL7 interfaces we basically have a standard that we can apply equally to all problems. Given that’s not the case I asked Glenn Johnson, a 25-year veteran of the software industry with good healthcare experience and a senior vice president with Magic Software Enterprises Americas, to give us some advice about what can go wrong with HL7 interfaces and how to avoid some of the pitfalls.

HL7 Interface Documentation: 6 Questions Hospital CIOs and IT Directors Should Be Asking Vendors

Wed, 12 Jan 2011 00:42:42 +0000

With healthcare IT integration tasks finally taking off because of Meaningful Use and other care collaboration requirements, HL7 interfaces will become even more important. After being involved in dozens of interfacing efforts over the past decade or so, I have found one of the most time-consuming aspects of integration is HL7 interface documentation: nobody has time to do it and it’s almost always treated as a “nice to have”. Given my experience I was thrilled to find that someone was finally putting together some solutions to make conformance specifications easier to document.

What kind of business model does your bright health IT idea have?

Fri, 07 Jan 2011 02:49:57 +0000

I speak regularly (and write irregularly) about the importance of iterating through to a solid business model before you get too far with your great healthcare IT product idea. Whatever new idea you have in health IT has likely been tried before and if it failed it was likely not because the tech didn’t work but they probably didn’t understand the difference between the payer of a system, the user of a system, and a benefiter of the system (what I call my “PBU” circle).

Fred Trotter’s Patient Centered Health Internet Makes Sense

Thu, 30 Dec 2010 22:56:07 +0000

If you haven’t had a chance to read it yet, check out Fred Trotter’s Patient Centered Health Internet article. He elegantly explains the simplicity of the Direct model vs. the the more complex (but ultimately still necessary) NHIN national model (read my article on NHIN at IBM if you’re not familiar with all these terms). There really isn’t a competition between the two models long-term because we’ll need both but the new Direct Project is coming along quickly enough that I recommend small offices and health systems really start to take a look at in 2011.

My eWeek interview about top 5 health IT trends in 2011

Wed, 29 Dec 2010 03:25:34 +0000

Brian Horowitz, who does some great writing over at eWeek and numerous other publications, interviewed me about what I thought the most important health IT trends will be in 2011. He published the results in his article entitled “Virtualization, EHR-Linked Devices, m-Health to Lead Health Care IT in 2011“. Brian captured what we discussed and made it even better by giving some concrete examples. Here’s some elaboration on each of the less often discussed trends we discussed:

Come see me at a speaking tour on EHR implementation and other health system IT priorities in Chicago, Newark, and Santa Ana

Wed, 17 Nov 2010 12:17:18 +0000

One of the most frequent questions I receive is how fellow CIOs, architects, technology directors, and other IT staff help ensure successful EHR implementations. EHR deployments are some of the most complicated efforts that any IT group can undertake but the successful ones all have some commonalities that go well beyond “be sure to get your requirements right” and other high-level platitudes. Nothing can guarantee success, but there are very specific things you can do to help make sure your team has a fighting chance.

How to identify spreadsheets and databases with protected health information (PII and PHI)

Wed, 20 Oct 2010 14:19:22 +0000

The nice folks from IBM’s developerWorks group asked me to write an intermediate-level set of instructions (with a little code) for how technical teams can identify and find databases and spreadsheets that might contain personally identifiable information (PII) and protected health information (PHI). The article is now available on IBM’s developerWorks, here’s the abstract: Identity theft and medical fraud are growing problems. They are so big the U.S. government is spending billions of dollars securing its own computer systems and has written thousands of pages of new regulations that you must follow to help protect your customer and employee data.

Social Networking Guidelines for Physicians, Office Staff and Patients

Mon, 18 Oct 2010 00:19:49 +0000

Ohio State Medical Association (OSMA) Legal Services Group has released their Social Media Toolkit for Physicians, Office Staff and Patients to “help physicians navigate through the world of online communication”. I’ve taken a quick look and it’s a terrific document with a good discussion of whether or not physicians should “friend” their patients. It covers many other aspects of medical practice social networking risks and benefits and is worth checking out.

The Keys To Building Health Care IT Companies

Sun, 17 Oct 2010 17:25:09 +0000

My friend Matt Ethington sent me a note about Forbes.com’s recent article on The Keys To Building Health Care IT Companies. The article nicely covers what they think are “the most important things to consider when creating a health IT firm.” As an advisor to many health IT firms I often repeat the same things mentioned in the article (verbatim from Forbes.com): The product must be a true “have-to-have,” not a “nice-to-have”.

Guest Article: How to decide which hospital systems to prioritize when planning for disaster recovery

Thu, 07 Oct 2010 13:24:06 +0000

I recently saw BridgeHead Software’s white paper on Healthcare Disaster Recovery and found it quite useful. I invited Charles Mallio, Jr., who is currently Vice President of Business Development for BridgeHead, to give us a summary of their thinking around DR in healthcare. Prior to joining BridgeHead, Charles worked for 12 years at MEDITECH, the last six of which he was responsible for worldwide customer technical support for all MEDITECH platforms.

Join West Wireless and yours truly in DC on Tuesday to learn more about VA’s $100 million Innovation Initiative (VAi2) program

Wed, 06 Oct 2010 01:15:51 +0000

If you’ll be in the DC area on Tuesday, you should drop by at the Healthcare Innovation Day, organized and brought to us by the non-profit West Wireless Health Institute. While the event is free, registration is required. You should register quickly because seats are limited and they’re running out fast. I’m planning to attend because I’d like to learn more about the Veterans Affairs Innovation Initiative (VAi2), a program in which about $100 million in grants are being awarded to innovative healthcare projects.

Give your opinion on whether you think RECs will deliver on their mission

Thu, 30 Sep 2010 21:34:01 +0000

Earlier this week the Office of the National Coordinator for Health Information Technology (ONC) announced the selection of the final two regional extension centers (RECs). The two RECs provide coverage for Orange County California and the state of New Hampshire. This brings the total count up to 62 and completes the national network of RECs. RECs are taksed with the mission of helping 100,000 primary care providers becoming “meaningful users” (MU) of EHRs in less than 24 months.

Guest Article: How desktop virtualization helps healthcare IT initiatives

Wed, 29 Sep 2010 01:24:16 +0000

I’ve been getting many questions about whether hospitals and physician offices should be considering desktop virtualization (there’s a fear that virtualization is not secure or may not work). To help answer the question, I invited Ryan Pope, a Product Manager at 2X Software which develops enterprise server-based virtual computing software, to tell us a bit about virtualization in healthcare. 2X software enables desktop virtualization and application streaming on personal computers and thin client devices and these guys know their stuff.

Boosting the productivity of clinical workers

Fri, 17 Sep 2010 11:39:44 +0000

McKinsey Quarterly recently published “Boosting the productivity of knowledge workers” (free registration required to access the link). While the article is not specific to clinical or IT workers, they wrote that “the key is identifying and addressing the barriers workers face in their daily interactions” which couldn’t be more true in a clinical setting. The article starts by asking “Are you doing all that you can to enhance the productivity of your knowledge workers?

How To Pick IT Consultants for Various Technical Tasks

Fri, 17 Sep 2010 10:42:55 +0000

The editors at The Journal of Surgical Radiology recently asked me to write a column on what I thought would be an important IT topic. Given the number of healthcare providers I’ve consulted with and counsel on a regular basis one of the most common questions I get is “how do I know which consultants I need?” With all the new work surrounding meaningful use and certification, this is an even more timely question so I wrote a column for them on “How To Obtain Quality IT Help“.

Guest Article: Top 10 tips for successfully using speech recognition in EHRs and healthcare apps

Sun, 29 Aug 2010 01:09:02 +0000

Moving away from paper is an automation journey that is both challenging as well as rewarding and choosing the right data entry technology is certainly one of the biggest challenges. Choose the right data entry mechanism and your journey is smooth; choose unwisely, and you’re in for a great deal of pain. There is no right mechanism for everyone so you’ll need to go through the various options with great care.

Meeting practical business and security challenges of healthcare apps in the cloud

Mon, 23 Aug 2010 00:55:31 +0000

There has been, understandably, a great deal of interest for moving all kinds of applications “into the cloud” (like software as a service or SaaS) because it can ease deployment and reduce costs. However, due to the nature of the healthcare data, security is a special concern. If you’re interested in moving to the cloud, check out an article I wrote last week for IBM entitled “Cloud computing by government agencies“; while it’s focused on public sector, it’s just as applicable to healthcare sector because the problems are identical.

McKinsey estimates that MU incentives may pay for less than 20% of hospital EHR roll out costs

Wed, 18 Aug 2010 10:36:06 +0000

One of my favorite publications, McKinsey Quarterly, published an article this month entitled “Reforming hospitals with IT investment” which speaks in plain business language about the costs and benefits of hospitals rolling out EHRs. The article requires registration but is otherwise free and is worth reading. Here are some of the highlights for a 200 bed hospital: They estimate the costs of EHRs to be around $80,000 to $100,000 per hospital bed They estimate the government incentives will bring in about $17,500 per hospital bed They say that if you use the high-end scenario of $100k per bed, the government incentives will amount to less than 20% of the cost They note that these costs do not scale linearly for larger hospitals.

Guest Article: What the low-tech checklist can teach techies about medical business processes and proper system design

Thu, 12 Aug 2010 09:27:37 +0000

I’ve often said that if you can’t repeat something, you can’t automate it — meaning trying to jump into creating software or systems before you have identified and fixed your human processes is always prone to failure. One of the best ways to understand if your process is repeatable is to create checklists and see if people follow them. I recently ran across Jacob Ukelson, Chief Technology Officer of ActionBase, who is somewhat of an expert on human process management and action tracking solutions that enable organizations to manage business-critical processes.

NIST says Meaningful Use Test Procedures have been approved by ONC

Wed, 11 Aug 2010 00:27:48 +0000

NIST updated Meaningful Use Test Approved Test Procedures page today: The Approved (Pending) Test Procedures were formally approved on August 2, 2010 for the Office of the National Coordinator for Health Information Technology (ONC) Temporary Certification Program. Notice of the approval appears in the August 9, 2010 Federal Register. The set of Test Procedures marked ‘Approved (Pending)’ will be reissued as ‘Approved’ by August 13, 2010. The approval process did not result in changes to the test procedures.

Guest Article: Lessons from the trenches – transitioning to EMR without risking data loss

Sun, 01 Aug 2010 18:06:22 +0000

The government’s promise of billions in EHR incentives has you interested in what you might be able to get so many of you are looking for advice and lessons learned from practices who have taken the leap to EMRs. I invited James Andrassy_, M.Ed,_ _PA-C__, who_ _has worked as a healthcare provider for the past 33 years to talk about some practical lessons. As the practice administrator and network engineer for Gastroenterology Associates of Cleveland and the Cleveland Center for Digestive Health and Endoscopy, he has seen many kinds of problems so_ _I asked him to talk about EMR data management, specifically data loss.

An overview of NHIN, NHIN CONNECT, and NHIN Direct

Thu, 29 Jul 2010 18:59:18 +0000

IBM developerWorks invited me to write an article that provides a technical overview of the National Health Information Network (NHIN) along with its related sub projects called NHIN CONNECT and NHIN Direct. The article was published today and covers how you can use CONNECT right now to create your own health information exchange (HIE) or connect to an existing HIE. In the article I also discuss NHIN Direct, a new project without immediately usable code yet, which you can use it to push or pull data from your medical systems to other healthcare systems directly (without necessarily going through an HIE).

My view on HIT (or other technical) certifications

Sun, 25 Jul 2010 15:39:51 +0000

On July 14th I conducted a seminar on How Meaningful Use Impacts Healthcare Data Management and IT Professionals. It was pretty popular and I got lots of questions at the event and many afterwards as well. One of the questions that kept coming up over and over again was about how to enter the healthcare IT field. One really good question was about certification and what i thought about it — here was the gist of the query:

NIST releases revised draft test procedures to adjust to the final Meaningful Use rules

Fri, 23 Jul 2010 01:57:26 +0000

As promised, NIST has released its revised draft test procedures to adjust to the final Meaningful Use rules that were unveiled last week. Here’s how they describe the latest updates: Approved (Pending) Test Procedures A Final Rule on an initial set of standards, implementation specifications, and certification criteria for adoption by the HHS Secretary was issued on July 13, 2010. NIST has completed its revisions of the draft test procedures to adjust to the Final Rule.

NIST planning to update draft test procedures tied to final MU rules on July 22

Tue, 20 Jul 2010 16:12:53 +0000

NIST just posted the following on their Health IT Testing and Standards draft test plans page: July 19, 2010 Note: A Final Rule on an initial set of standards, implementation specifications, and certification criteria for adoption by the HHS Secretary was issued on July 13, 2010. NIST is currently updating the Test Procedures to reflect the Final Rule and anticipates publication by July 22, 2010. NIST’s test plans are what will be used by the certification bodies and form the basis of what really will be required in EHRs so it’ll be important to keep any eye on these.

Final MU rules are out but don’t forget, you’ve still got all of 2011 and 2012 to get paid

Thu, 15 Jul 2010 15:48:13 +0000

As you’re probably already aware, the final meaningful use rules were released by the government about 48 hours ago. Overall, I’m impressed with the transparency, quality, and timeliness of the final regulations. I think the “little guy” won one because the MU rules have mostly been reduced from the original requirements and the two additions are relatively easy. While I don’t think we should be doing any top-down initiative like MU, given that it’s the law, HHS, CMS, and NIST is doing as good a job as they can in writing the rules and attempting to make them understandable.

Join me for a free webinar on “How Meaningful Use Impacts Healthcare Data Management Professionals” on Wednesday, July 14th

Fri, 09 Jul 2010 16:38:10 +0000

I’ve been doing a good deal of coaching and consulting on what Meaningful Use really means to technology professionals lately so I was pleased to accept an invitation by Embarcadero to lead a webinar on that subject for a data management audience. Join me next Wednesday at 2:00p EDT to learn about the impacts of meaningful use and certification of electronic health record systems to data management professionals. Learn what healthcare Data Management Professionals need to know about achieving HITECH meaningful use and certification beyond the obvious list of MU requirements.

Medical Fusion Conference for physicians looking for a career change moves to Vegas in November

Sun, 27 Jun 2010 00:03:39 +0000

A doctor friend of mine and I were talking about our HIMSS trip and how many physicians told us were getting “sick and tired” of the business of medical practice. I spoke with a number of docs there looking to get out of medicine and into technology, marketing, management, or other fields. I thought for sure that there couldn’t be that many physicians looking for a career change. Boy, was I wrong.

Unintended consequences of clinical automation and EMRs

Fri, 25 Jun 2010 20:13:00 +0000

One of my favorite new blogs is healthsystemCIO.com. There is some terrific reporting and more importantly unique and value-added coversations going on between healthcare CIOs. I ran across the recent “Dissecting Physician Resistance to CPOE” posting and thought it was worth sharing. Timothy Hartzog, M.D., Medical Director of IT, Medical University of South Carolina said the following about how implementing Computerized Physician/Provider Order Entry has unintended consequences but all the lessons are applicable to any clinical automation.

Finally, a government-run website you can trust for HHS/CMS EHR Icentives Program answers

Tue, 22 Jun 2010 15:18:21 +0000

I was pleased to see the following website being launched recently: http://www.cms.gov/EHRIncentivePrograms If you’re looking for a “just the facts ma’am” style of answers to your frequent questions about HHS’s EHR Incentives program (the ARRA HITECH stimulus bill) I would recommend starting there now. For example, here’s what they say about the certification program: How Certification is related to the EHR Incentive Programs The EHR Incentive Programs require the use of certified EHR technology, as established by these new set of standards.

Guest Article: Be sure you have proactive networking monitoring in place before you install clinical software

Tue, 22 Jun 2010 13:45:05 +0000

Not everybody is jumping on to the ARRA HITECH (stimulus bill) bandwagon and installing EMRs and clinical software, but many are. There are many problems that are difficult to solve before you implement EHRs and EMRs — like getting optimal data entry procedures, working out the proper codes, setting up the right workflows, etc. However, one major problem I’ve seen during my recent installs, which is readily solvable using technology, is that networks often aren’t ready for the software.

Guest Article: We should be implementing digital signatures even before jumping into EMRs

Tue, 22 Jun 2010 13:21:56 +0000

Healthcare organizations should be embracing digital signatures but often think it’s much harder than it really is. Some organizations are resorting to timely, expensive and cumbersome paper-based processes because they think they need to move to full EMRs or EHRs in order to gain any of the benefits of digital signatures. Fortunately, advances in digital signature technology have made it possible for Healthcare organizations of any size to embrace digital signatures and gain a competitive advantage through eliminated paper handling costs and expedited processes.

Guest Article: Is your network optimized for EMRs and large document traffic?

Mon, 21 Jun 2010 13:54:32 +0000

In the rush to install EMRs tech folks often forget that you need to make sure that your network can handle the (usually significant) load that medical records automation will add to your network infrastructure. I invited Jon Mills of of Plixer International, Inc., a Maine-based software development company that specializes in network traffic analysis using NetFlow and other flow-based monitoring technologies to talk about network optimization. Here’s what Jon had to say about optimizing network traffic for EMRs:

Start the certification engines, ONC says bodies will be ready to certify by “the end of summer”

Fri, 18 Jun 2010 18:15:43 +0000

I was at a HHS ONC press conference today and the dates for selecting certifying bodies was announced. As of today if you’re interested in being a certification body you must request the HHS Certifying Body application in writing On July 1 ONC will start accepting applications By the “end of the summer” (HHS’s words) there will be one or more certifying bodies open for business (accepting products) By “this fall” (again, their words) there will be fully HHS certified products available One important clarification was made by ONC — there is no grandfathering in CCHIT or previously certified products.

Why MDs Dread EMRs

Thu, 17 Jun 2010 20:19:20 +0000

The Journal of Surgical Radiology recently published my “Why MDs Dread EMRs” article in this quarter’s journal. Check it out, it’s available in both print and online formats.

Is CCHIT dead?

Wed, 16 Jun 2010 20:32:43 +0000

Chris Thorman over at Software Advice had a nice CCHIT-related posting a couple of days ago: EMR Ratings: How Relevant Is CCHIT Certification In the HITECH Era? Chris wrote that one doctor called and asked: “Is CCHIT dead?” Here’s part of his response: Dead? No. But it appears that the organization’s influence is waning. In the spirit of point counterpoint, here are three reasons why CCHIT could become less relevant in the EHR industry:

Free advice for selecting EMRs and other medical software

Wed, 16 Jun 2010 15:57:37 +0000

All the talk around Meaningful Use, EMRs, EHRs, regional extension centers, and other buzzwords are utterly confusing the physician practices and staff who need to make decisions about what software to buy. I’ve put together some free resources over at HITSphere called Free Medical and Healthcare Software Buying advice. If you’re confused and would like to see some easy to use tools for how to decide what to look for and what to buy and could use some hand-holding you should check it out.

NHIN Direct & CONNECT 3.0 Update at Government Health IT Conference & Expo in Washington D.C

Fri, 11 Jun 2010 19:32:53 +0000

NHIN, the National Health Information Network, is something you’ll need to be familiar with if you’re doing any work in the healthcare IT industry. Next week at the Government Health IT Conference & Expo in Washington D.C you’ll be able to get technical overview of NHIN and related subprojects called NHIN CONNECT and NHIN Direct. You can use CONNECT right now to create your own health information exchange (HIE) or connect to an existing HIE.

Where Have We Come in a Year? Social Media and Its Impact on the Healthcare Industry

Thu, 10 Jun 2010 17:02:06 +0000

Last year I had the privilege of chairing and keynoting the Healthcare New Media Marketing Conference in Phoenix, Arizona. I enjoyed the event because the attendees were practitioners from the provider space (many hospitals, health systems, etc). This year I was invited back to the 2nd Annual Conference, which is being held in Chicago next Monday and Tuesday, to talk on the topic of “Where Have We Come in a Year?

What VA’s winners of health IT innovation competition says about the industry and MU

Mon, 07 Jun 2010 13:40:44 +0000

About a week ago Secretary of Veterans Affairs Eric K. Shinseki announced the selection of 26 winning ideas in the Veterans Health Administration / Office of Information and Technology (VHA/OIT) Innovation Competition. Here’s the list from the website: Reducing health care associated infections using informatics CPRS-based automated queries & reports Robust VA forms search engine Augment CPRS with standards-based decision support engine Enhanced care management to facilitate case management and chronic disease care Integration of behavioral health lab & CPRS for mental health primary care Edischarge pilot program Show patient picture in CPRS CPRS enhancement for veteran-centered care “Parking” outpatient prescriptions to prevent waste Suicide hotline: be a hero, save a hero Touch screen device support for nursing triage of patients Tools for front line veteran eligibility staffing VA-wide core collection of knowledge based information resources Integrate VistA surgery package with CPRS Illustrated medication instructions for veterans Share verified insurance info via use of the master patient index Veteran online tracking of mail prescription delivery Search function in CPRS Accessible contact information for all assigned care providers Online radiology protocoling tool integrated within CPRS/VistA Wireless voice communications with hands free options Improved access to military personnel records Brief resident supervision index Emergency medical response team communication Reduce unnecessary/duplicate lab tests by rules-based algorithms All of these ideas have merit and I think the VA’s been innovative about how they’ve gathered the ideas.

How to commercialize your healthcare IT and media products

Sun, 06 Jun 2010 16:28:34 +0000

The National Institutes of Health Commercialization Program (NIH-CAP), designed to assist promising life science companies bring their technologies to market, is a nation wide program funded by NIH. NIH invited me to talk to this year’s class of SBIR/STTR grantees about how to commercialize their Healthcare IT, Media, and Training products at the 12th Annual NIH SBIR/STTR Conference held in Raleigh, NC last week. I’ve done this event for about 4 years now and it’s very well put together and heavily attended by companies looking to launch healthcare products.

Will RECs accidentally wreck innovation in the EMR market on their way to helping small practices?

Sun, 06 Jun 2010 15:13:36 +0000

The Federal Government is granting hundreds of millions of dollars to Regional Extension Centers (called “RECs” and pronounced like “wrecks”) to help small physician practices benefit from healthcare information technology solutions. RECs are designed to offer consulting and technical support to help accelerate adoption of Electronic Health Records (EHRs). The purpose of the RECs is to provide guidance on which products to buy, help reduce prices of software through group purchase agreements, and give technical assistance on implementation and deployment.

Guest Article: Healthcare IT Lessons Learned at a Growing Practice

Sun, 06 Jun 2010 03:21:25 +0000

To share how a smaller healthcare practice grew its business through the use of technology, I’ve reached out to Therese Rodda, owner and executive director of Friendship Heights Rehabilitation Center and a physical therapist with more than twenty years experience. Therese has spent her entire career working within my home Washington, D.C. metropolitan area in hospital, outpatient and home care and was the former Community Health Professional of the Year nominee by the Maryland National Home Care Association.

Additional NIST Certification Draft Test Procedures updates

Sun, 25 Apr 2010 15:00:13 +0000

Check out the NIST Draft Test Procedures site; the following test documents have been updated this week: Incorporate laboratory test results Report quality measures Submission to immunization registries Public health surveillance They’re making good progress on the procedures but there is still quite a long way to go before the final ones are approved and made public. Has anyone been through the details? What do you guys think so far about the quality and objectivity of the test procedures?

NIST hosting a summer workshop on usability in health IT

Sat, 17 Apr 2010 12:07:59 +0000

NIST recently announced that they are hosting a workshop on July 13 in Gaithersburg, Maryland entitled Usability in Health IT: Strategic, Research, and Implementation. Here are the particulars from the announcement: Sponsors: <td width="71%" height="68" valign="top"> <a href="http://www.nist.gov/">National Institute of Standards and Technology</a> (NIST) and Technology Office of the National Coordinator for Health IT Agency for Healthcare Reseach and Quality </td> Audience: <td width="71%" height="26" valign="top"> Health IT professionals.

Harvard Business Review wonders whether the U.S. health technology sector has run out of gas

Mon, 12 Apr 2010 23:39:32 +0000

Recently I wrote that Innovation in healthcare IT is dead (but hopefully only temporarily). I thought, after my HIMSS trip, that there was very little innovation happening probably because of the deep freeze caused by all the regulatory activity and new Meaningful Use and Certification requirements. Today I saw one of my favorite publications, Harvard Business Review, ask a more general question: Has the U.S. Health Technology Sector Run Out of Gas?

NIST Draft Test Procedures added and updated

Sat, 10 Apr 2010 01:25:44 +0000

Check out the NIST Draft Test Procedures site; the following test documents have been updated: Drug-drug, drug-allergy, drug formulary checks Medication reconciliation. Electronically complete medication reconciliation of two or more medication lists by comparing and merging into a single medication list that can be electronically displayed in real-time. Access control. Assign a unique name and/or number for identifying and tracking user identity and establish controls that permit only authorized users to access electronic health information.

OSCON, the most important Open Source conference, adds a healthcare track in 2010

Fri, 09 Apr 2010 17:18:16 +0000

I got a note about OSCON from Fred Trotter this morning and read it with great enthusiasm: I am happy to spread the news that OSCON, probably the most important Open Source conference in the country, will have a healthcare track in 2010. Andy Oram has explained the decision to add a healthcare track to OSCON. They have asked me to help promote the conference and I want to be sure that our community offers up the very best in talks and technical content.

On April 7 CCHIT will offer Preliminary ARRA Certfication with free bridge to Final

Wed, 24 Mar 2010 01:18:17 +0000

CCHIT has probably been hearing lots of rumblings about the ONC and HHS’s inability to provide meaningful use certification fast enough for providers and hospitals to get start with product and vendor selection. At healthSystemCIO.com Anthony reports that CCHIT will be offering, staring in just a couple of weeks, their Preliminary ARRA Certification once again. According the healthSystemCIO: The program materials, including revised program policies, applications, criteria, test scripts and other guidance will be available at http://www.

Several more NIST draft test procedures updated for EMR certifications

Tue, 23 Mar 2010 16:31:32 +0000

This morning I noticed that NIST has updated more test procedures on their Draft Test Procedures page. The CPOE test procedures, generate patient lists, record demographics, generate patient reminders, timely access, and electronic copy of discharge information were all updated.

Webinar on Certification Programs for HIT NPRM March 25, 2010 4:00 – 5:00 p.m. EDT

Fri, 19 Mar 2010 20:48:38 +0000

This came from the nice folks at ONC this morning: On March 25, 2010 from 4:00 – 5:00 p.m. EDT, The Office of the National Coordinator for Health Information Technology (ONC), with the National Institute of Standards and Technology (NIST), will present a webinar on the recently released Certification Programs for HIT Notice of Proposed Rulemaking (NPRM). Public comments on the NPRM are now being accepted. The temporary certification program’s comment period ends April 9 and the permanent certification program’s comment period ends May 10.

NIST updates draft test procedures page for medication reconciliation

Tue, 16 Mar 2010 17:42:17 +0000

As I’ve mentioned in previous posts, there’s been some good progress by NIST to create meaningful use test procedures for certifying bodies that will need to evaluate EMRs. They already have 8 test documents for various MU criteria including up-to-date problem list, active mdications list, active allergy list, vital signs, BMI calculations, growth charts plotting, smoking status tracking, and (as of today) medication reconciliation. I contacted the nice folks at NIST and wondering if they’d have an RSS feed or something for the changes — they said they liked the idea and would put something into place as soon as they could.

26 ways to grow your healthcare IT business

Thu, 11 Mar 2010 17:30:59 +0000

ExecutiveBiz.com has nice post this week on 26 ways to grow your healthcare IT business. There are some good ideas in the posting and are summarized here. Recognize healthcare IT as more than an IT opportunity. Maintain specific focus on each and every customer. Help your team see the larger picture. Speak the language of your customers. Participate in the standards-setting conversation.

HITECH incentives payment & meaningful use training from Medicare (CMS) itself

Wed, 10 Mar 2010 04:31:05 +0000

A few weeks ago the Office of E-Health Standards & Services at the Centers for Medicare & Medicaid Services (CMS) did some nice training on the EHR Incentives NPRM. This is a great overview of the ARRA HITECH act as it is understood by CMS and should override any understandings by mere mortals like us. It includes information about meaningful use, eligibility, core quality measures, and payments. It’s worth checking out.

Medical Fusion Conference for physicians looking for a career change

Wed, 10 Mar 2010 03:12:32 +0000

CCHIT halts interim Meaningful Use Certification pending publication of NIST test scripts

Tue, 09 Mar 2010 15:38:32 +0000

A friend of mine just sent out the following note: There have been developments in the last few days that have caused CCHIT to pause “providing direction on the requirements for test step demonstration for the Interim Final Rule Stage 1 criteria. The reason is because NIST is now publishing Test Methods and Procedures on their website that Certifying Bodies will have to comply with. Therefore, we (CCHIT) will be reviewing their published materials and revising our test scripts for Meaningful Use to match.

How to Select the Right EMR, a must-get eBook

Tue, 09 Mar 2010 11:56:02 +0000

John Lynn and I spent a few hours together at HIMSS this past week and he gave me a preview of his new How to Select an EMR eBook. When he first told me about it, I figured it was yet another how to go guide with generalities and high level advice. However, as he and I walked through the various sections I became more and impressed to the point where I now recommend it as a must-read for anyone that’s looking to purchase an EMR and wants to know how to make sure they don’t get sold a lemon by a vendor.

Understanding the 12 major application clusters in mobile health (mHealth)

Fri, 05 Mar 2010 01:01:09 +0000

The nice folks at the mHealth Initiative invited me to join their merry band of mobile phone-based healthcare applications proponents at a conference they held in DC last month. Claudia Tessier kicked off the conference with this great presentation that describes major mobile phone application clusters. It describes mobile phone usage in patient communication, point of care documentation, disease management, body area networks, education programs, pharma/clinical trials, professional communication, public health, emergency medicine, and financial applications.

If you sell health IT products, be sure you know about Regional Extension Centers

Thu, 04 Mar 2010 12:33:13 +0000

One of the interesting things funded by the HITECH Act was the creation of the Health Information Technology Program. That program invests in Regional Extension Centers to offer consulting and technical support to help accelerate meaningful use of Electronic Health Records (EHRs). All told there are likely going to be 70 (or more) regional centers across the country. One of the major tasks of a Regional Extension Center is to provide guidance on which products to buy.

Innovation in healthcare IT is dead (hopefully only temporarily)

Thu, 04 Mar 2010 06:30:41 +0000

Ok, maybe not dead but certainly in a coma and on life support. I just got back from HIMSS ’10 in Atlanta. While the energy was great, the people I met were very cool, and the venue and staff made the event quite enjoyable, I left underwhelmed by the substance of what’s being offered and a little worried about one of my favorite industries (health IT). Since I spend plenty of time outside of healthcare IT doing technology strategy work in the financial, web 2.

The lessons our EMR industry can learn from past failures in the CRM industry

Wed, 03 Mar 2010 17:24:46 +0000

A few days ago I received a great question about Customer Relationship Management (CRM) and Sales Force Automation (SFA) from a reader via e-mail: In a recent post you made reference to the similarities with CRM and SFA. I was and have been following that topic, like you, for the last decade. My question for you is, do the primary drivers for this come from the same places with different names, or from different places.

More HIMSS tips for HIT vendors looking to make their case

Thu, 25 Feb 2010 13:04:39 +0000

James Gibson over at Gibson Consultants (a specialized executive search firm targeting healthcare solutions providers and the payor market) saw my recent posting about John Moore’s tips for HIT vendors presenting to us analysts at HIMSS and sent me a note about guest posting on his blog that talks about a similar subject. I wanted to thank James for pointing me to his Tips from a media coach: how to do a trade show right article.

Thank goodness, the FDA could start regulating healthcare IT systems

Wed, 24 Feb 2010 23:37:52 +0000

A few years ago I wrote that the FDA should be paying closer attention to healthcare IT systems and consider regulating those systems the same as any other medical devices. After all, some healthcare IT systems can kill just as easily as medical devices. I hate quoting myself, but here’s what I wrote back in 2005: If the FDA were paying attention, they would see that lots of hospital information systems, especially those making it over to the clinical side through clinical decision support, should really be regulated.

Tips for HIT vendors speaking to analysts at HIMSS

Mon, 22 Feb 2010 19:47:57 +0000

John Moore over at Chilmark Research is one smart cookie; in addition to being a world expert on PHRs , he’s a great analyst on general healthcare IT (HIT) topics, too. With HIMSS coming up next and analysts like myself and John being requested to review firms and their products, John has done a great public service (and personal service to me) by posting his Top 5 Do’s & Don’ts for Speaking with Analysts at HIMSS.

Physician Office Usage of Electronic Healthcare Records Software

Thu, 18 Feb 2010 02:02:40 +0000

SK&A recently surveyed 180,000 medical sites as to their current usage of EHR. That’s one of the largest national surveys I’ve seen — the numbers are about what we expect but it’s great to see that someone actually spent the time doing real research instead of just quoting other smaller surveys. Seems like the SK&A guys are serious about healthcare data. Nice work.

Guest Article: Human Centering in Healthcare IT

Tue, 16 Feb 2010 23:39:29 +0000

I’ve been spending a lot of time on human-computer interactions in healthcare technology these days (both hardware and software). It’s a very hard problem to solve, especially with complex systems like EMRs. To help talk more about how to better design patient-centric healthcare technology, I’ve reached out to Steven Deal, Vice President and systems engineer for Deal Corp, a Dayton-area engineering research firm that specializes in this kind of work. Steven is also volunteer secretary for the Center for Innovation in Family and Community Health, a non-profit organization in the Dayton area so he knows about healthcare technology. Here’s what Steven had to say about human centering of healthcare IT:

One approach to reining in healthcare spending is the Patient Centered Medical Home (PCMH). The PCMH model is intended to reinvigorate primary care by focusing on patient needs and desires. Primary care reduces costs by systematizing healthcare delivery; it counters the piece parts (specialist-driven) approach that results in redundant, costly, and often unnecessary, procedures.

The PCMH delivery system is said to be patient centered, but just what does it mean to be “centered?” Requirements for centering preferentially address the needs of one or more of a system’s stakeholders. Alternately, a system could be centered on a particular enabling technology. For example, personal computer systems were built around the enabling technology of microprocessors. So if you are patient centered, you are first and foremost addressing the needs of patients. This approach seems like a no-brainer, since healthcare, or more correctly medical care, is all about addressing patient needs? What else would you center it on?

There are actually many options and a lot of them are being implemented today. For example, healthcare could be centered on doctors, on payers, on medical schools, on hospitals, on the government healthcare systems (Medicare, Medicaid), on insurance companies, on research, on pharmaceuticals, or on information technology. If you look closely at the principles of PCMH, it’s not too hard to see that it is really partially doctor centered and partially payer centered. The tug-of-war that is the Washington healthcare-reform debate is really about which stakeholder will come out on top.

Meet the bloggers (and other New Media personalities) at HIMSS

Tue, 16 Feb 2010 22:56:05 +0000

I’m hoping to see many of my friends at HIMSS this year and I’m working with great folks like John Lynn to setup several unofficial meetups at HIMSS for those of us reading or writing blogs or other New Media tech like Twitter, LinkedIn, Facebook, etc. Our previous HIMSS meetups have been fun and productive at the same time (they’re great networking events). I say unofficial meetup because HIMSS has some official sessions with bloggers which are a bit more formal (and equally valuable).

Report: How to get your hands on $900 Million in Federal Health IT and $70 Billion in Health Tech

Tue, 16 Feb 2010 21:22:11 +0000

Here’s a new report you’ll like if you’re interested in getting your contractor hands on federal healthcare tech dollars (including health IT). Here’s the introduction from the report: The U.S. Federal government will spend more than $385 billion on healthcare – not including Medicare spending – in GFY2010. Nearly $70 billion of that will go to government contractors in the area of healthcare technology. Note that $70 billion will be spent on healthcare technology, not simply health IT.

Event: Find out how to tap the billions of dollars being spent by the government on healthcare technology

Tue, 26 Jan 2010 19:50:34 +0000

If you’re in the DC area, you might be interested in attending FedSources InFocus Event on Healthcare Technology. FedSources is a company that provides market intelligence around government contracting and opportunities. I’ll probably be attending so if you’re planning on attending let me know and we can catch up at the event. The event is being held at the McLean Hilton in Tysons Corner, VA on Thursday January 28 at 5:00p.

$99 Wii Balance Board Outperforms $17,885 Medical Device

Tue, 26 Jan 2010 00:10:27 +0000

I love these kinds of stories. Last week Gizmodo posted In Early Tests, $99 Wii Balance Board Outperforms $17,885 Medical Rig which was initially reported in New Scientist’s Wii board helps physios strike a balance after strokes. Basically, the story revolves around a paper published by Ross Clark in which Clark’s team compared a $99 Wii Balance Board (used in gaming and exercising while connected to the Wii console) to an almost $18,000 force platform.

Let there be light: HHS publishes interim final rules on Initial Set of Standards, Implementation Specifications, and Certification Criteria for EMRs

Thu, 31 Dec 2009 14:30:45 +0000

Scrambling to meet the end of year deadline set forth in the ARRA HITECH statute, HHS hits the mark with its release of the interim final 45 CFR Part 170, Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology. I will have more to say about the contents over the coming days and weeks as I review it. My initial reaction is that the content is pretty good — it’s not very precise nor is it actually independently verifiable (yet) but the folks at HHS have done well.

Beware EMR bullies quoting federal stimulus rules

Mon, 21 Dec 2009 23:14:49 +0000

I’ve been hearing a lot of stories these days about EMR companies telling potential physician customers that they need to buy a sophisticated or “full blown” EMR right now in order to get any stimulus funds. Some of my readers have asked whether this is true or not so let me set the record straight. Yes, it’s true that the ARRA HITECH Act clearly states (in section 4101, page 353) that the government shall provide “incentives for adoption and meaningful use of certified EHR technology.

Social networking 101 for physicians

Fri, 18 Dec 2009 13:31:59 +0000

Massachusetts Medical Law Report’s Social networking 101 for physicians is a great summary for physicians who are looking to get into social networking or have already been participating for some time. It’s got some great tips that sound obvious but should be heeded carefully: Be mindful of patient confidentiality. Remember that your patients are not your ‘friends.’ Monitor your web presence regularly. Take advice from online doctors’ forums with a grain of salt.

Markle gives sound advice on “Meaningful Use of Health IT” to policy makers (again)

Tue, 15 Dec 2009 13:22:33 +0000

The Markle Foundation has been giving some very reasonable advice on the use of IT and technology in general for the healthcare industry. Their most important advice, if heeded by lawmakers, would put to effective use the billions of dollars that have been earmarked for healthcare IT in the ARRA stimulus bill. I loved what they said in their letter to Frizzera (CMS), Blumenthal (ONCHIT), and Orszag (OMB). On page 3:

Guest Article: Tips to help prepare for EMRs, even before you choose your software

Tue, 24 Nov 2009 15:30:29 +0000

Given my recent postings on how to ease into technology before jumping head-first into EMRs, many readers wrote back asking additional questions about how else they should get ready for EMRs. To make sure readers get the best software selection advice, I reached out to Sheldon Needle, who is president and founder of CTSGuides.com, publishers of software evaluation materials. They have a free Medical Software Selection kit for indepth reviews of leading EMR, scheduling, and billing software, performance ratings for over 800 features, and a template to plan and manage your software demos.

Study of 3,000 hospitals shows little benefit from EMRs – similar to CRMs and SFA?

Sun, 22 Nov 2009 05:43:17 +0000

This week The New York Times reported in Little Benefit Seen, So Far, in Electronic Patient Records that: The nation is set to begin an ambitious program, backed by $19 billion in government incentives, to accelerate the adoption of computerized patient records in doctors’ offices and hospitals, replacing ink and paper. There is wide agreement that the conversion will bring better care and lower costs, saving the American health care system up to $100 billion a year by some estimates.

Don’t drink the Kool-Aid: Tips for easing into medical technology if you’re afraid of EMRs

Sun, 15 Nov 2009 18:51:56 +0000

SoftwareAdvice.com recently posed the following questions to its readers in a survey format: “Are more doctors buying electronic medical records than before? Or, has the Stimulus bill only brought out the tire kickers?“. The results of the survey are available here; while the survey wasn’t scientific and it didn’t have enough participants to draw wide scale conclusions, the results do imply a general feeling of positive momentum towards the purchase and implementation of EMRs.

Guest Article: Open Source EMRs for free clinics

Sun, 15 Nov 2009 17:46:21 +0000

Kevin Clifford and I were chatting about his experiences in taking a Michigan-area free clinic live on an open source EMR and I was very interested to share it with others. Kevin said he volunteered at the free clinic because he wanted to serve his community and said that there are many other such free clinics in need of IT improvements in Michigan and elsewhere. I asked him to write a quick summary of what he did and how it worked.

Breaking into the Healthcare IT job market

Wed, 11 Nov 2009 02:43:03 +0000

One of the most popular questions that I am routinely asked about is how to get a job in the (now hot again) healthcare IT market. I was doing a little poking around on JuJu.com, a job search engine, and the nice folks there gave me some interesting statistics based on their usage patterns: IT positions make up approximately 3.5-7.0% of all healthcare jobs and this number is on the rise.

And then there were 2: Drummond Group Plans to Certify Electronic Health Records

Thu, 05 Nov 2009 22:06:05 +0000

I saw this on PRweb today: Drummond Group Inc. announced today that it will submit to become a certifying body upon the release of the Office of the National Coordinator for Health Information Technology (ONC) requirements for certifying bodies for Electronic Health Records (EHR). Drummond Group has been approached recently by numerous EHR software and services companies that need to be certified. This may be good news for the EMR/EHR industry — a second certifying body (CCHIT was the first) has been at least announced.

Health Wonk Review: Killer viruses and the undead public option

Thu, 29 Oct 2009 21:15:33 +0000

This week’s Health Wonk Review (our Health Policy and IT Carnival) is available at Tinker Ready’s Boston Health Blog. It’s got lots of scary photos but don’t let that keep you from seeing what’s going on this week.

DeepDyve: Like iTunes for Scientific and Medical Papers & Research

Thu, 29 Oct 2009 01:56:20 +0000

John Biggs at TechCrunch says <a href=““http://www.techcrunch.com/2009/10/28/deepdyve-like-the-itunes-for-scientific-papers/>DeepDyve is like iTunes for Scientific and Papers. The DeepDyve site, launched today, offers full-text search of scientific articles along with 99 cent downloads and a subscription service that allows you to read as many papers as you’d like. Articles cost 99 cents for 24 hours and an unlimited plan for $19.99 a month. A $9.99 plan allows you to access 20 articles per month for up to seven days each.

GE wants to fund your healthcare technology idea

Wed, 28 Oct 2009 20:25:14 +0000

General Electric (GE) unveiled its $250 million GE Healthymagination Fund which was created to make investments in promising healthcare technology companies. If you’ve got some good ideas and think you can get the concepts to market, start your business plan and get in line for the money. Like most VCs, they will probably be very conservative and take time to make a decision so don’t go after their money if you can find non-VC funding.

Is EMR Adoption on the Rise? Or is the market frozen until next year?

Tue, 27 Oct 2009 21:38:49 +0000

I got a note from the nice folks at Software Advice reminding us that this Friday marks the close of the first reporting period for Recovery Act funds. Any grants or loans awarded between February 17th (the signing of the bill) and September 30th will be reported in the survey (and subsequently show up at www.recovery.gov). We are all especially eager in the healthcare community to see the results of reporting to find out if the Stimulus Bill has had any impact on EMR adoption rates.

101 Ways to Use Twitter in Your Hospital

Thu, 15 Oct 2009 18:29:57 +0000

The LPN to RN Blog has a nice posting on 101 Ways to Use Twitter in Your Hospital. It’s worth checking out.

The Looming Problem in Healthcare EDI: ICD-10 and HIPAA 5010 migration

Sat, 10 Oct 2009 16:26:40 +0000

On Jan. 15, 2009 the United States Department of Health and Human Services released the final rules for the updated X12 Electronic Data Interchange (EDI) transaction definitions, version 005010 to be used in conjunction with HIPAA and completed by January 2013. At the same time, the International Classification of Diseases (ICD) standard has been bumped from ICD-9 to ICD-10 with a compliance date of October 2013. These aggressive compliance mandates, coupled with the close relationship between HIPAA transaction sets that can directly refer to ICD-9 or ICD-10 codes have health industry IT professionals scrambling.

How RxNorm fits into clinical interoperability

Thu, 06 Aug 2009 01:47:49 +0000

These days I gets lots of emails with questions like “What’s RxNorm?” and “How should we use UMLS in our software?” These subject areas are important to cover because if you’re doing any work in healthcare interoperability and don’t know about UMLS and code sets like RxNorm then you really should get up to speed quickly. Charlie Harp over at ClinicalArchitecture.com has put together a great 15 minute overview of RxNorm and the UMLS Metathesaurus.

10 Words I, too, Would Love To See Banned From Press Releases

Sat, 01 Aug 2009 16:41:35 +0000

I just ran across Robin Wauters’ post over at TechCrunch about 10 Words I Would Love To See Banned From Press Releases. It’s a great summary of my own frustrations as a blogger who sees tons of press releases a week. Don’t get me wrong, I love seeing emails about new products and services and I welcome submissions of press releases or other announcements to media@healthcareguy.com. Like most bloggers, I’m happy to get engaging emails and I respond to almost all messages that are addressed specifically to me (as opposed to a general mailling list) and look like they weren’t sent as a mass e-mail.

Guest Article: Why Doctors Hate Electronic Medical Records

Sun, 26 Jul 2009 15:06:34 +0000

_ Most of us in the healthcare IT believe the ARRA (stimulus) bill is a Good Thing for the industry in general. Many existing companies will be able to sell more products and many new companies will be formed to create electronic medical records solutions. I was talking to Dr. Bill Cast last week about EMRs and what he and other physicians thought about them in general and I got some great feedback.

Reminder: Free and Open Source Software (FOSS) in healthcare unconference in Houston next week

Sat, 25 Jul 2009 01:03:57 +0000

I grew up in Houston and normally it’s not exactly the best place to be in the middle of Summer (it’s pretty hot and humid); however, this Summer is different because we have the Free and Open Source Software (FOSS) in healthcare unconference taking place next week. This is a conference/unconference about Free and Open Source Software in Healthcare. Open Source was specifically mentioned in the Hi-Tech portion of the stimulus bill!

Conducting market research for your healthcare IT app

Thu, 23 Jul 2009 23:20:59 +0000

Many of you out there are looking at the ARRA (stimulus) bill for ways to sell your healthcare IT wares to healthcare providers. One of the weaknesses of most tech-focused companies is that don’t spend enough time on market research to figure out where to sell their products. That’s primarily because it’s not always easy to get useful statistics so here’s a little advice I give to my startups when they ask “where do I find out how many doctors there are in the country?

Ingenious use of tech: Training Med Students in Second Life (virtual) Hospitals

Tue, 21 Jul 2009 21:52:27 +0000

Discover Magazine asks Can Training in Second Life Teach Doctors to Save Real Lives? While many in the tech world are looking at the ARRA Stimulus Bill’s money being spent on EMRs and giving the world the thousandth version of a medical records system it’s great to see some creative technologists are using their brains on simulations and training programs that could actually make better doctors, not just more efficient administrators.

Guest Article: Selecting or Designing iPhone and Mobile Software for Physicians

Tue, 21 Jul 2009 21:32:02 +0000

_I get a lot of questions asking for advice on how to build mobile software and one of the most popular questions is about how and where to save data on a mobile device (because of HIPAA and privacy rules). I reached out to Adam Kenney, a software engineer pMDsoft who leads a team of developers focused on mobile charge capture. Adam and his team have been building medical apps for mobile platforms and his insights arise from direct experience managing the design, development, and support of native applications for the Palm, BlackBerry, and iPhone.

Guest Article: Status of CCHIT and certification for ARRA

Wed, 15 Jul 2009 12:57:09 +0000

Many people have been e-mailing me asking about the status of CCHIT and ARRA certification. Jim Tate, President of EMR Advocate, is an experienced project manager in the implementation of both EHR and Practice Management systems and consults with EHR vendors regarding interface and functional specifications, marketing strategy, documentation and CCHIT certification. Many of us have had to put our plans on hold because of the pending government regulations so I asked him to provide us a quick summary of what direction he thinks the current certification winds are blowing.

Federal standards body is looking for some health IT usability experts

Mon, 13 Jul 2009 22:32:49 +0000

Last week I was approached but one of the federal government standards bodies that is putting together some advice and standards around healthcare IT usability. They are seeking usability experts to join people like me on their advisory council. If you’re a healthcare IT usability specialist and would like to be nominated to join the experts panel please drop me a note or leave your name and contact information as a comment on my blog.

Guest Article: Can Twitter help stop or slow down human virsuses?

Fri, 10 Jul 2009 14:36:48 +0000

Chris Thorman, who blogs about medical software at Software Advice, gave me a call recently and talked to me about Twitter’s potential use in tracking disease outbreaks. As evidenced by Twitter’s front-and-center role in the “Second Iranian Revolution,” the micro-blogging tool has emerged as a serious communication channel. Chris talked to me about how he thinks Twitter is every bit as relevant in medicine as it is in politics, business and personal communications.

Top 50 Blogs to Help You Further Your Healthcare Career

Fri, 10 Jul 2009 12:44:05 +0000

With all the attention being paid to healthcare these days (given the Stimulus bill and HITECH Act provisions) and with the assumption that a ton of money will be poured into the healthcare sector at any time there are lots of folks wondering how to get into the health tech field. I found this posting on Top 50 Blogs to Help You Further Your Healthcare Career on the e-Health News Blog has many of the same blogs and sites that I recommend to my readers.

Join me and others from CDC, FDA, HHS, & NIH to discuss HealthIT Adoption via Social Media

Thu, 09 Jul 2009 20:32:52 +0000

I’ve been invited to moderate a panel at next week’s Driving the Adoption of Health IT Through Innovations in Social Media conference in DC. It will be held on July 16 from 8a until about noon at the Amplify Public Affairs office at 919 18th Street, NW, DC. If you’ll be in the DC area, please join us. My panel is called “How Social Media Improves Communication & Collaboration For Public Health” and extends on some of the topics I presented in last month’s keynote at the Healthcare New Media Marketing conference in Phoenix.

A Tour of the Healthcare New Media Marketing Landscape

Mon, 22 Jun 2009 10:54:40 +0000

Last week I had the privilege of chairing and keynoting the Healthcare New Media Marketing Conference in Phoenix, Arizona. I really liked the event because the attendees were actual practitioners from the provider space (many hospitals, health systems, etc). It was great talking to people who were actually producing the content — web directors, PR heads, and other marketing leaders from Cleveland Clinic, Duke University Health System, Henry Ford Health System, Mayo Clinic, Emory Healthcare, and many other prestigious healthcare providers.

Guest Article: Why Games Matter in Healthcare

Sun, 31 May 2009 15:47:34 +0000

The Fifth Annual Games for Health Conference will be held June 11–12 in Boston, MA. The conference will focus on the many intersections between videogames, health and healthcare. I’ve written quite a few times recently about games in healthcare and how the IT around games in health is important to us. The conference is very affordable and there’s a 15% discount by entering bos09 during registration but the early bird pricing expires today.

How Social Media Can Improve Communication & Collaboration During A Public Health Crisis

Fri, 29 May 2009 02:32:22 +0000

My friends at Ozmosis, the Physician to Physician social network, have put together a nice presentation entitled “Health Alerts & Lessons Learned from H1N1”. They’ve done a good job describing how simple social media tools can help clinicians communicate with each other during a public health crisis. It’s worth checking out.

Guest Article: How medical students can get into Health IT

Wed, 06 May 2009 12:55:24 +0000

Many med students often write to me asking about how they might get into the healthcare IT space while continuing their studies or after they graduate. Kat Sanders, who regularly blogs on the topic of online phlebotomy classes at her blog Health Zone Blog speaks routinely to med students so I asked here to share her thoughts. She’s got some great ideas for students and is willing to take more questions via e-mail or comments in this posting.

Amazon offers free cloud computing services to educators and students

Sun, 03 May 2009 22:45:07 +0000

I don’t usually write out product announcements but this one really caught my eye: Amazon Web Services (AWS) in Education. Here’s what they have (direct from their website): AWS in Education provides a set of programs that enable the worldwide academic community to easily leverage the benefits of Amazon Web Services for teaching and research. With AWS in Education, educators, academic researchers, and students can apply to obtain free usage credits to tap into the on-demand infrastructure of Amazon Web Services to teach advanced courses, tackle research endeavors and explore new projects – tasks that previously would have required expensive up-front and ongoing investments in infrastructure.

Health Wonk Review at Health Care Policy and Marketplace Review

Sun, 03 May 2009 17:46:29 +0000

Bob Laszewski did a great job summarizing and describing this week’s activities across the healthcare IT and policy blogosphere in his Health Wonk Review (HWR) edition. Check it out and learn about what transpired this week.

SOA in Healthcare Conference June 2-4 in Chicago

Sun, 03 May 2009 17:41:54 +0000

The general hype of Service-oriented Architecture (SOA) has calmed down quite a bit which means that practicality and reality is settling in for the design pattern. With concepts like Web Oriented Architecture (WOA) and Resource Oriented Architecture (ROA) getting more attention these days and the “Death of SOA” being pronounced by the likes of Burton Group, it’s clear that the pundits need something new to talk about. My feeling is that SOA as a way of defining reusable and portable services for creating composite application as opposed to siloed code components and applications acting independently is still very meaningful and applicable.

Moving to two-factor authentication in healthcare apps

Sun, 03 May 2009 16:17:11 +0000

Most of us who work in the technology field know that single-factor authentication (using just a username and password combination) is not as secure as two-factor (or multi-factor) authentication. The Federal Government and large businesses alike either require multi-factor authentication or at least support it through the use of a physical access card or something similar. Until recently, it’s been difficult to get multi-factor security working in modern apps because they’ve either been expensive or difficult to implement.

Public Health & Technology Conference at Harvard next week

Sat, 25 Apr 2009 22:36:16 +0000

Here’s the announcement: The Public Health & Technology (PHAT) Forum at the Harvard School of Public Health is proud to announce the first Public Health & Technology Conference, co-sponsored by the Department of Health Policy & Management and the Social Entrepreneurs In Health Student Group. Despite health IT’s promise of better, faster, and cheaper health care, adoption of electronic health records in the US remains low. This conference brings together many of the leaders in the field to explore the potential to use health IT to improve health delivery, the challenges of health information exchange and the impact of the 2009 American Recovery and Reinvestment Act on health IT.

Markle Foundation presenting “Getting Health IT Right Under the ARRA” at Newseum in DC on Thursday

Sat, 25 Apr 2009 14:17:19 +0000

As we all know, the terms “meaningful use” and “certified” will be defined through (hopefully) a new healthcare collaborative and not legacy vendors process this year. The Markle Foundation, which is a philanthropic organization that advises the government on various matters, is presenting their view on what “meaningful use” should mean and how that definition should drive the “certified” terminology debate. I got an early look at what they’re presenting and I like what they have to say.

NCVHS Executive Subcommittee Hearing Defining “Meaningful Use” to be held April 28th and 29th in DC

Sat, 18 Apr 2009 00:15:32 +0000

Yesterday the National Committee on Vital and Health Statistics (NCVHS) announced that it’s holding a public hearing to define the ARRA’s “Meaningful Use” of EMRs concept. NCVHS is of course one of the oldest public boards that advises the Secretary of Health and Human Services (HHS). Here’s their introduction: The NCVHS Executive Subcommittee will hold a public meeting on April 28-29, 2009 to help define and clarify the term “Meaningful Use,” a term used in the HITECH Act (part ofthe American Recovery and Reinvestment Act ARRAA).

Are medication alerts useless since most clinicians override them anyway?

Fri, 17 Apr 2009 13:39:00 +0000

A February 2009 internal medicine study entitled “Overrides of Medication Alerts in Ambulatory Care” concludes the following: Clinicians override most medication alerts, suggesting that current medication safety alerts may be inadequate to protect patient safety. In my work I have certainly seen many alerts constantly being overridden but I didn’t realize how big an issue it was until I read this article. Here’s what else they said: Background Electronic prescribing systems with decision support may improve patient safety in ambulatory care by offering drug allergy and drug interaction alerts.

Physicians are not technology averse

Fri, 17 Apr 2009 13:09:42 +0000

As a thought leader in the healthcare IT space I get a lot of emails that blame physicians for not changing their behavior and not more more easily accepting information technology. The IT solutions folks and vendors often complain “if only physicians would just accept our system the hospital would benefit, the government would get data, insurance claims would be processed faster, etc.” Because physicians don’t jump to change their behavior and adopt IT immediately they are pegged as being technology averse.

ManageMyPractice.com: Technology, Information & Resources for the Medical Practice Manager

Fri, 17 Apr 2009 11:42:58 +0000

I ran across this interesting blog today. Found some well written postings that are IT related: Open Your Mind: 29 Uses of Twitter for Medical Practices Quick Reference for Acronyms and Buzzwords of ARRA and HITECH The 5 IT Skillsets Every Physician Practice Manager Needs to Succeed in 2009 and Beyond Listservs vs Twitter: Are You Ready to Make the Step into a Brief New World? Twitter Will Change Healthcare!

HIMSS Discussion Drafts on Meaningful Use Open until April 17

Mon, 13 Apr 2009 19:28:24 +0000

In case you haven’t already done so, please take a moment to review the HIMSS Discussion Drafts on Meaningful Use site. Here’s the purpose of the site; I think they’re trying to be transparent and we need to help them out: Welcome to the HIMSS discussion forum on the definitions of meaningful use of certified EHR technology. As identified in the American Recovery & Reinvestment Act, hospitals and physicians have the opportunity to earn Medicare incentive payments for a specific time period – if they meet the definition.

Guest Article: What will make healthcare software usable?

Mon, 13 Apr 2009 11:04:50 +0000

Last month I posted several entries about how difficult most healthcare software is to use – those articles garnered lots of “yes, you’re right” type of comments along with a number of emails asking for help on how to improve usability. Usability describes the “ability to use” something — the goal for a usable system is to make it easy to use. Given how hard it is to actually make something easy to use (yes, ironic), I invited an expert in this field — Paul Nuschke, a usability specialist at Electronic Ink – to write about what it takes to make software usable, with emphasis on healthcare IT systems.

Guest Article: Leveraging Technology to Drive Patient Centered Medical Home Initiatives

Mon, 13 Apr 2009 10:27:02 +0000

Of all major healthcare technology strategies, patient centered medical home (PCMH) initiatives, while still in their infancy, have the potential of significantly improving outcomes. I’ve been following the medical home concept and technology surrounding the initiatives for some time now and am excited to hear consumer electronics companies, traditional IT firms, and finally existing healthcare technology providers finally getting into the fray. To explain the medical home concept I invited Ned Moore, CEO, Co-founder & Chairman of Portico Systems, to explain what the medical home is all about.

What consumers think about online health resources, PHRs, EHRs, and other important topics

Mon, 06 Apr 2009 19:01:03 +0000

I’m a big fan of evidence over eminence when it comes to making decisions around healthcare IT. Deloitte does some great research and this morning I saw this 2009 Survey of Health Care Consumers. As the website says: The 2009 Survey of Health Care Consumers, conducted by the Deloitte Center for Health Solutions, is Deloitte’s second annual study of health care consumers’ attitudes, behaviors and unmet needs. It offers health care industry leaders and policymakers a comprehensive and timely perspective about how Americans approach their health, health care and health insurance.

Video of NIH Lecture on Advances in Clinical Interfaces Available

Wed, 01 Apr 2009 11:52:13 +0000

NIH’s Biomedical Computing Group putting together a lecture on advanced clinical interfaces. The event was webcasted and the video is available here. If you’ve been doing good clinical interfaces for a while you’re not likely to find lots of new information in the lecture but it will reiterate some of the most important aspects of good design and user interfaces for complex systems like clinical decision support. If you’re new to healthcare IT, you will get a good deal of information on why designing easy to use interfaces for physicians is really hard to do right.

CCHIT set to meet with healthcare open source advocates

Fri, 27 Mar 2009 22:46:11 +0000

A number of open source advocates, including myself, have been recommending for a while that CCHIT make its certification process more amenable and friendly to free and open source software (FOSS). I wanted to congratulate CCHIT for taking the request seriously – they agreed to meet with FOSS advocates at HIMMS. They’ve been considerate enough to setup a conference call capability so that people who can’t travel to Chicago can meet via screen share remotely (after all, open source developers don’t exactly have a travel budget).

Health Wonk Review up at Healthblawg

Thu, 19 Mar 2009 13:20:15 +0000

Thanks to David Harlow for a great and attractively illustrated post: the “Spring has just about sprung” edition. Check it out.

Connecting to the Nationwide Health Information Network (NHIN)

Thu, 19 Mar 2009 12:49:34 +0000

Federal Computer Week hosted an eSeminar talking about the NHIN. It’s a good presentation and if you’re in an healthcare IT space with any relevance to RHIOs, you should check out the Federal Health Architecture overview below. ONCHIT – Connecting to the Nationwide Health Information Network (NHIN) the Road Ahead Publish at Scribd or explore others: Presentations & Slid magazine healing

Guest Article: Clinical Interoperability – The Antics of Semantics

Tue, 17 Mar 2009 11:49:11 +0000

In this fourth installment explaining clinical interoperability in plain English, Charlie Harp talks about semantics or the “meaning of data”. Charlie is the CEO and founder of Clinical Architecture and has spent the last twenty years designing and developing software solutions in the healthcare industry. Here’s what he had to say in his final part of a series I’ve be doing on interoperability. Clinical Interoperability – The Antics of Semantics

Guest Article: The Hottest Jobs in Healthcare IT

Mon, 16 Mar 2009 21:59:14 +0000

Given all the attention being given to healthcare IT these days (especially because of the stimulus bill), many of my readers were wondering how to get into the market (jobs, contracts, etc). I asked Sarah Scrafford, who regularly writes on the topic of pharmacy technician online programs, to tell us what she’s seeing these days. Here’s what she had to say about the healthcare IT job market. There’s an inherent satisfaction in working in the healthcare field – you feel fulfilled because you’re helping people get better and get over ailments that get them down.

Client/Server vs. ASP/Web-Based in Healthcare IT

Thu, 12 Mar 2009 15:01:20 +0000

I get tons of email for healthcare IT advice (which I love, so keep the questions coming) and every once in a while a question comes along that I decide to answer here since I think it will be interesting to many readers. Here’s a great one from yesterday: I am a frequent reader of your blog. I find your writing very pertinent to my own business. I run a development shop that creates EMR software and our company is currently in a debate about the future of our application architecture.

EHR certification work begins: Nominations requested for Health IT Federal Advisory Boards (FACAs)

Wed, 11 Mar 2009 00:40:49 +0000

A friend of mine, Jim Rose, reminded me that a request for nominations for two Health IT Federal Advisory Boards (FACAs) went out from HHS today. Thanks for pointing that out, Jim. These advisory boards will lead the guidance and direction on standards, implementation specifications, and certification criteria for health information technology adoption. I would love to represent all us “little guys” who are striving for practical solutions to healthcare standards and certification criteria.

Guest Article: How to do real clinical interoperability right now

Mon, 09 Mar 2009 01:55:12 +0000

Last week I asked Charlie Harp to explain what clinical interoperability is – in plain english. Charlie is the CEO and founder of Clinical Architecture and has spent the last twenty years designing and developing software solutions in the healthcare industry. Here’s what he had to say in his third part of a series I’ve be doing on interoperability. In this last article he presents some techniques that can be used right now to do real clinical interoperability.

Guest Article: Why does clinical interoperability matter?

Mon, 02 Mar 2009 15:23:34 +0000

Last week I asked Charlie Harp to explain what clinical interoperability is – in plain english. Charlie is the CEO and founder of Clinical Architecture and has spent the last twenty years designing and developing software solutions in the healthcare industry. Here’s what he had to say in his second part of a series I’ll be doing on interoperability. Now that we have a documented definition for clinical interoperability and its macro components, the next reasonable question is: “Why is clinical interoperability important?

Guest Article: Getting beyond the hype and hyperbole – what is clinical interoperability?

Tue, 24 Feb 2009 12:55:37 +0000

There is so much hype around healthcare and clinical data interoperability – I get emails all the time asking about what all of it means and the comments I received on the recent articles about it have been great. I’ve posted about interoperability before but I thought I’d reach out to Charlie Harp to see if he can explain it in plain English. Charlie is the CEO and founder of Clinical Architecture.

A great visual for healthcare IT interoperability

Thu, 19 Feb 2009 13:49:46 +0000

Bart Collet posted a comment to Dr. Rowley’s recent guest article on interoperability – he said the following diagram is a great way to show how inflexible many healthcare IT systems are these days: I love the picture, thanks Bart. Too many of our healthcare IT systems look like the device on the bottom – to make matters worse, many vendors don’t even have the three button Bart has in his photo.

HIPAA violations are finally starting to be punished

Thu, 19 Feb 2009 12:08:45 +0000

AP reported this morning that CVS is settling patient information investigation with HHS and FTC to the tune of $2.25M. Here’s the gist of it: Employees at CVS pharmacies left the labels and other items in open trash bins outside stores, according to the Federal Trade Commission and the Department of Health and Human Services. The company also did not have adequate policies for disposing of that information, and did not sufficiently train employees to dispose of the information properly, the agencies say.

Guest Article: The challenge of interoperability across local and hosted solutions

Thu, 19 Feb 2009 01:20:24 +0000

Dr. Robert Rowley is a practicing family physician in the San Francisco Bay Area, and has been using electronic medical records systems for 10 years. Recently he joined Practice Fusion as its Chief Medical Officer where he helps build a hosted web-based EMR free to physician end users. Dr. Rowley has written regularly in print media as well as blogs about a variety of aspects of ambulatory EMRs so I asked him to share with us his thoughts about a really hard problem: clinical data interoperability, especially for hosted solutions connecting to on-premise solutions.

Evidence over Eminence in Medicine and Healthcare

Fri, 13 Feb 2009 14:21:54 +0000

Recently I’ve been sitting in many meetings in which I am amazed as to the lack of science and evidence when it comes to ideas in medicine and healthcare in general and healthcare IT specifically. It’s mind-boggling sometimes that people can nod their heads in agreement with a well known expert or authority in a field even if they say silly or downright stupid things from a scientific point of view.

CouchDB could be a viable alternative to relational databases for storing patient data

Fri, 13 Feb 2009 11:50:24 +0000

A while back I wrote the Data Models in Healthcare series of articles. Beyond relational databases, which is of course my primary storage platform, one of my favorite techniques for managing the structured and semi-structure databases is to use XML. XML is a great persistence model for storage of schema-free data (and sometimes schema-fixed data). However, XML is not a natural model to do aggregation, consolidation, and analytics from various data sources (which is sometimes a pretty big requirement in modern health IT apps) so it’s something to be avoided in certain circumstances.

Usability Guidance for EHRs and Personal Health Records

Thu, 12 Feb 2009 11:56:34 +0000

My last posting on healthcare IT application UI complexity was quite popular and got many comments both online and via email (thanks everyone). Readers were wondering if there are other sites or reports available to help improve usability. The folks at User Centric, Inc have a nice practice around exactly this kind of guidance. Two of their free reports will be very helpful to you if you’re interested in usability guidance:

Explaining Healthcare IT application UI complexity

Mon, 09 Feb 2009 02:19:27 +0000

A friend of mine sent me this drawing a little while ago. I have performed many usability analyses on healthcare IT software and I usually end up writing many pages of a “summary report” which should probably include the diagram shown above. It crystallizes the reason why HISs, EMRs, and other healthcare IT software gets a bad rap – they are often more complex to use and significantly more difficult train than many other commercial applications.

Health Wonk Review at Health Business Blog

Sun, 08 Feb 2009 16:48:14 +0000

The latest Health Wonk Review, the healthcare policy and technology blogosphere’s carnival, is now up at David Williams’ excellent Health Business Blog. Check it out.

Guest Article: Google Health and HealthVault App Integration from the trenches

Tue, 27 Jan 2009 16:41:08 +0000

I liked what the folks are doing at TrialX, especially their integration with HealthVault and Google Health so I invited them to write share with us what they’ve learned. Chintan Patel is a co-founder and the CTO of TrialX, a startup that is developing social and semantic technologies to enable patients find matching clinical trials using Personal Health Records (PHRs). They’ve got some good ideas around easing patient recruitment for trials.

Free and Open Source Healthcare IT unconference in Houston this summer

Sun, 25 Jan 2009 16:36:51 +0000

Fred Trotter, one of the most influential and outspoken voices for free and open source solutions/software (FOSS) in healthcare, just announced that he’s helping put together the FOSS in healthcare unconference. An “unconference” (in case you’re not familiar) is a meetup or gathering of people in which the participants themselves (not the conference organizers) run the conference and decide on the topics and facilitate the conversations. Unconferences don’t have high fees and don’t usually have sponsored presentations like most conventional conferences do.

Zotero can help with medical research and daily healthcare Information Management work

Sun, 25 Jan 2009 15:46:01 +0000

Most of us in the healthcare industry are constantly doing research of one kind or another (doctors have to keep up with new procedures and the latest research, nurses have to keep up with latest techniques, etc). Most of us just end up using simple but inefficient tools like files on our desktop, folders on a USB drive, MS Word for editing, printouts for clippings, etc. Dr. Rich Olson, a surgeon friend of mine, pointed me to the Zotero Firefox plugin this weekend.

Astronauts have checklists, why not surgeons?

Sun, 25 Jan 2009 15:25:59 +0000

The debate around checklists for physicians in general and surgeons specifically has raged for decades. When a task becomes sufficiently complex (like astronauts controlling spacecraft or pilots flying aircraft) it has been shown that simple multi-step checklists, that professionals are required to document completion of, can significantly reduce risky procedures and work. Astronauts are pretty bright, why do they need checklists but surgeons don’t? According to the New England Journal of Medicine, a safety checklist in the operating room has the potential to reduce complications and improve survival rates of patients after surgery.

Nice new web-based physician Marketing and Social Networking site

Mon, 05 Jan 2009 03:52:25 +0000

The folks at Phyzoom have recently released a social networking site for physicians that adds a nice twist – it’s helpful for marketing services between physicians and other parts of their healthcare ecosystem (insurance, hospitals, etc). I’ve seen and reviewed a number of physician-oriented social networking sites (like Sermo and Ozmosis) but Phyzoom seems to be the first one looking to help doctors with marketing and increasing patient visits. It’s an excellent idea.

Free e-Prescribing with NEPSI and Integration Challenges

Wed, 17 Dec 2008 17:02:31 +0000

Many Physicians have been asking me for what my suggestion is for e-prescribing both now and in the future. My simple answer for them is that unless you have an EMR fully functional and working in your practice and e-prescribing is built-in, you should give the NEPSI guys a shot: they are offering free and pretty decent e-prescribing nationwide to any Physician willing to sign up. If you’re a NEPSI user, help out your fellow physicians and tell us:

Clinical trials Patient Recruitment done right with Web 2.0 and Social Networking

Wed, 17 Dec 2008 13:27:10 +0000

One of the biggest challenges in conducting clinical trials is recruiting the right patients. It’s an often expensive, time-consuming, and difficult process where you usually need contract firms or other specialists to do your recruitments. This week I learned about a New York based healthcare IT startup, TrialX, which is doing some pretty innovative stuff around patient recruitment by using Google’s and Microsoft’s personal health platforms to help match patients with specific trials.

Save some brain cells, use MedCalc on your Mobile Device (iPhone, Palm, Windows)

Thu, 11 Dec 2008 01:36:46 +0000

MedCalc is a free medical calculator for the iPhone, Palm OS and Windows Mobile. It’s pretty useful and well done. The best thing about it (other than being helpful on a daily basis) is that it’s open source so it can be expanded upon easily. Check it out.

Healthcare IT spending is not dead in Hospitals (yet)

Tue, 09 Dec 2008 21:15:41 +0000

The nice folks at NAHIT sent out a note about their new survey of about 144 CIOs that captured technology executive’s views on healthcare IT spending. The report’s key findings include (these are direct quotes from the report): More than half of the CFOs/VPs Finance (55%) are experiencing slight or significant delays in accessing capital and expect the financial crisis to last another 12 to 24 months.**** CFOs/VPs Finance are delaying or lengthening timeframes for completing new facilities or facility upgrades (74%,) deferring IT equipment purchases (57%) and delaying or lengthening timeframes for implementing health IT initiatives (52%).

iPhone and iPod Touch Medical Applications

Sun, 07 Dec 2008 13:23:52 +0000

Dr. Joshua Schwimmer wrote an article earlier this year called The New 3G iPhone, Doctors, The App Store, and Medicine in which he tried to predict what kinds of iPhone (and of course iPod Touch) applications would be available once Apple opened up the platform to 3rd party programmers. This week he posted an update called Medical Applications in the iTunes App Store for the iPhone and iPod Touch in which he highlights some of the almost 100 medical apps available for the Apple mobile platform.

AMIA report on Open Source Implementations of Healthcare Software

Fri, 05 Dec 2008 01:29:28 +0000

Fred Trotter sent out a link today to the new AMIA report entitled Free and Open Source Software in Healthcare 1.0. Fred reminded us that this is the first time he’s seen a serious count of installations of open source software in non-government institutions. ClearHealth seems to be the leader with over 3 million patient records managed at over 830 sites. Not exactly taking the world by storm but certainly good news that free stuff is being used to do important healthcare data management.

Guest Article: A Tech-savvy Physician’s View of Patient Social Networks

Sun, 30 Nov 2008 16:16:56 +0000

Dr. Jason Bhan is a practicing family physician and an Assistant Clinical Professor and Community Preceptor at the Medical College of Virginia and is board certified in Family Medicine. Dr. Bhan is Co-Founder and Chief Medical Officer of Ozmosis__, a great physician-only online resource for sharing medical knowledge between trusted practitioners. He is regarded as an emerging national expert in the applications of social media to healthcare and medicine and writes a regular blog on these topics and more at his blog.

Consumerism and Healthcare IT Innovations Summit at Ohio State University on Nov 17

Fri, 24 Oct 2008 11:08:46 +0000

The nice folks from Ohio State University Center for IT Innovations in Healthcare sent me a note that they are holding their second annual “Healthcare IT Innovation Summit” on November 17 in Columbus, Ohio. It seems like a very interesting gathering and I might be attending. They are inviting thought leaders to explore questions such as: What effect does consumer-driven healthcare have on leveraging technology resources? What are the strategies behind unleashing the true power of technology innovation in health care?

Digitizing natural handwriting from any surface – useful for clinicians?

Sun, 12 Oct 2008 13:05:56 +0000

As most of us in healthcare realized long ago, pen and paper is a very difficult technology to replace and compete with. It doesn’t matter how fancy our computers get, how nice tablets become, or how good the voice recognition features are, most healthcare workers spend a majority of their time on paper. The IOGear Mobile Digital Scribe is probably the closest device I’ve seen that may allow doctors to switch to a non-traditional pen/paper technology.

Dinosaur MD says “Make Mine Paper” and “no thanks” to EMR vendors

Sat, 11 Oct 2008 01:35:30 +0000

A friend of mine sent me a note to take a look at Make Mine Paper by a blogger who calls himself “#1 Dinosaur, MD”. It’s a well written article that explains why there are some physicians who will never use an EMR. Some choice words: Until there is a single, interoperable system in wide use, EMRs will never have the portability and versatility of paper. Just imagine the chaos that would result if doctors’ offices used 8.

Does putting an EMR into a primary care practice make life hell for a year?

Sun, 28 Sep 2008 22:32:04 +0000

A friend of mine sent me this link – “Beware of the EMR ‘Ponzi scheme,’ warns physician leader” — earlier this week. The article starts off by saying: Healthcare IT does not necessarily make life easier for primary care physicians, says a leader in the movement to make medicine more efficient and patient-centered. “When you put an EMR into a primary care practice, your life is hell for the next year,” said L.

Top 50 Health 2.0 Blogs

Thu, 18 Sep 2008 11:01:58 +0000

The nice folks over at RNCentral.com have posted their list of the top 50 Health 2.0 blogs. This humble blog is listed in their Health and Technology section and I thank them for their consideration.

There is no such thing as a comprehensive health record

Tue, 16 Sep 2008 10:38:17 +0000

The folks at SoftwareAdvice.com recently published EHR vs. EMR – What’s the Difference? It’s a good, but at times too high-level and could have been a bit more substantive in terms of real problems and potential solutions (but I suspect this was “landscape” summary so I can’t fault them too much). It talks about what is an EMR, EHR, and PHR from a definitional perspective and goes on to give a good summary of how often each term is used (with Google stats) and why vendors are still calling themselves EMRs.

Eldercare social network and community site is good

Tue, 16 Sep 2008 10:22:02 +0000

Caring.com is an excellent example of how to use Web 2.0 for improving patient care — by targeting not just those affected by illness but actually helping those that are caring for the patients. Caring.com’s focus on eldercare (adult children caring for aging parents) is a good one and should prove profitable. I really like their “to do list” ideas that give actionable advice and specific steps for how adult children can care for their elderly patients.

Texting for Insurance Deductibles and Copays

Mon, 15 Sep 2008 16:53:48 +0000

George over at Patient Centric Healthcare blogged about using mobile phones’ texting capabilities to get insurance company deductibles and other information. Nice idea, worth reading — somebody will make some money off of it. He says: Imagine texting your plan for an immediate response on: Your deductible Your FSA balance Your copay on a specific drug Whether a provider is in network The status of your prior authorization A list of formulary alternatives

Medicine 2.0 in Toronto

Sun, 14 Sep 2008 16:39:13 +0000

Neil Versel recently wrote about Medicine 2.0 here and here. Check out the postings, it looks like there was some nice stuff going on there. The proceedings of the conference are freely available.

How To Demo Your Startup

Fri, 05 Sep 2008 00:48:11 +0000

This is an article I wish I wrote. It’s about how to demonstrate your startup or business idea to a stranger on the phone or in an audience. Since people pitch me their products (which I enjoy, of course), I see lots of demos every month. At then end of each demo I almost always give advice on how the demo could have gone better and the folks at TechCrunch have captured it quite nicely.

Surviving the Shakeout in Consumer Health Sites

Wed, 27 Aug 2008 10:21:07 +0000

The folks over at Health Content Advisors talk about the business side of online consumer health firms. With big firms like Revolution Health not doing well, it’s getting a little scarier if you don’t have deep pockets to make the advertising model work. As a blogger whose been around the block and online for a while I get lots of new ideas pitched to me from all the various healthcare technology companies and I get excited about new consumer plays but by the time I’ve finished interviewing and talking to the firms about their business models I’m less enamored because many of the firms have no clear path to profitability.

XTS’s Citrix reporting tools Assist with HIPAA Compliance

Wed, 27 Aug 2008 01:47:42 +0000

It has been some time since I last wrote about XTS, a rapidly growing virtualization management vendor focused on the Citrix market. In my recent interview with Eric Spiegel, CEO, I found out that XTS has had many important changes this year. On the product side, they launched a new, more powerful version of their analysis and reporting solution and renamed it Introspect for XenApp. Although it’s not designed for it, Introspect is a very useful tool for performing HIPAA compliance checks and audit reports of which users have been accessing specific applications and servers that might contain patient data.

Phreesia is now an even better example of consumer driven healthcare technology done right

Thu, 14 Aug 2008 17:50:36 +0000

I introduced Phreesia on my blog back in December 2005. I was impressed by the company back then because they took a real problem — improving the patient check-in process — and solved it using some deceptively simple technology that would actually be used. They definitely haven’t rested on their laurels; since then, Phreesia has continued to improve the patient experience. Phreesia remains the Patient Check-in Company but they’re just getting even more deeply embedded within the physician office workflow.

MyFamilyHealth is a great Web 2.0 health site

Thu, 31 Jul 2008 10:36:17 +0000

The folks at MyFamilyHealth.com have combined online genealogy, social networking, and basic personal health record management for a single and eminently useful purpose: learning more about your family’s medical history to help improve your own health by better understanding your genetic risks. It will be fascinating to see how people use it over the next few years. I built my own family history account this morning and found these important benefits:

Guest Humor: Parody of Healthcare IT Vendors

Wed, 30 Jul 2008 02:11:53 +0000

A surgeon friend of mine, who’s been a great proponent of practical healthcare IT solutions, prepared this nice little parody of a fictitious HIT/HIS vendor named Extormity’s press release :-). Here’s what my friend wrote after some bad experiences with a few healthcare IT firms at his hospital: Health care information systems provider Extormity, Inc. (NASDAC:EXTRT) announces a product class action law firms have been developing in concert with Extormity corporate leadership.

MedPedia medical Wiki lauching at the end of the year

Wed, 23 Jul 2008 17:20:10 +0000

TechCrunch posted today about MedPedia: MedPedia is a new project, currently in development, that will offer an online collaborative medical encyclopedia for use by the general public. In order to keep the content accurate and up-to-date, content editors and creators have to have an MD or a PhD. Several highly-esteemed medical colleges will be contributing content to MedPedia, including Harvard Medical School, Stanford School of Medicine, UC Berkeley School of Public Health, and University of Michigan Medical School.

The New England Journal of Medicine reports on EMR adoption by Physicians

Tue, 15 Jul 2008 23:35:27 +0000

When the New England Journal of Medicine speaks, people in clinical circles listen. In the most recent issue of the Journal, in an article entitled “Electronic Health Records in Ambulatory Care — A National Survey of Physicians” the authors report the following results from the survey: Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. In multivariate analyses, primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records.

Productivity strategies for Doctors

Mon, 26 May 2008 15:40:29 +0000

Life hacks are productivity strategies that solve everyday problems — especially problems related to information overload. Joshua Schwimmer, a Physician, recently put together and presented Life Hacks for Doctors (as a slide deck, not a paper). It’s a nice presentation and I recommend all Physicians take a quick glance — it will only take a few minutes to run through it.

Why Google Health and HealthVault are not covered by HIPAA

Sat, 24 May 2008 13:39:50 +0000

Fred Trotter sent out this note to several health IT bloggers recently. Recently slashdot referenced two uninformed comments on Google Health offering. http://science.slashdot.org/article.pl?sid=08/05/23/0520223 The problem here is that HIPAA should NOT cover Google Health or HealthVault. This issue now dominates this debate, and I wanted to specifically point out some of the problems with this thinking. http://www.fredtrotter.com/2008/05/23/in-all-fairness/ Fred does a great deal of wonderful healthcare and IT writing. His latest argument for why HIPAA does not cover Google’s or Microsoft’s PHR offerings makes a lot of sense and is well worth reading.

Why Doctors Are Heading for Texas

Sat, 17 May 2008 14:28:53 +0000

Normally I write about Healthcare IT but today’s Why Doctors Are Heading for Texas article in the Wall Street Journal caught my attention. Here’s why: Today obstetricians, surgeons and other doctors might consider reviving the practice. Over the past three years, some 7,000 M.D.s have flooded into Texas, many from Tennessee. [Why Doctors Are Heading for Texas] Corbis Sam Houston. Why? Two words: Tort reform. In 2003 and in 2005, Texas enacted a series of reforms to the state’s civil justice system.

HealthCampMD in June

Thu, 15 May 2008 02:32:02 +0000

HealthCampMD (http://barcamp.org/HealthCampMd) will look at Social Networks, Web 2.0 technology and Data Portability as it might impact the Health Care industry. This will be a meeting of minds of technologists and health care professionals interested in the evolution of the Health Care industry. Check out the information page at http://barcamp.org/HealthCampMd and sign up! If you live nearby in MD, VA, or DC please pass along this message.

High-impact and High-value Medical Innovation

Sat, 10 May 2008 15:39:06 +0000

I love it when my readers send me links and tips and I got a great one from Bioxpert (name withheld per request): Hi, Longtime reader, first time tipper. Love your blog! I went to a fantastic presentation at Harvard Med School on High Impact Clinical Innovation -techniques for physicians to innovate within their specialties. It was sponsored by CIMIT and features a presentation by Zen Chu, a local venture capitalist and medical device entrepreneur.

The Top 100 Open Source Software Tools for Medical Professionals

Tue, 15 Apr 2008 12:21:39 +0000

The folks at LiveSmarter have put together their list of the Top 100 Open Source Software Tools for Medical Professionals. It includes the following subject areas: Medical Billing and Electronic Medical Records Antivirus, Security and Privacy Communications Graphics and Imaging Content Management Tools Research and Reference Multimedia Storing Patient Information General Tools that Work for Everyone Collaboration Tools Storing, Sharing and Managing Files and For Patients It’s a nice list, worth checking out.

Guest Article: Practical Identity Management for Healthcare

Mon, 07 Apr 2008 22:52:58 +0000

In the past, I’ve written a number of postings on Identity Management for Healthcare. I recently contacted Ash Motiwala, CTO of Identropy to weigh in on the subject. Ash and Identropy have plenty of real-life experience deploying Identity Management systems in the healthcare arena, and are industry innovators with their managed identity services platform, iMIS. Identropy also provides identity infrastructure assessments, integration services and workshops to aid organizations find their identity management roadmap.

Non-profit foundation “Doctors in Peril” helps physicians wronged by IT, EMR, medical device, and other vendors

Mon, 07 Apr 2008 02:41:15 +0000

A friend sent me a note about this forum posting at HIStalk recently. It’s about an interesting new foundation called Doctors in Peril. Here’s the original text: Hi, My name is Jim Edison and I work part time for a private, non-profit foundation called www.doctorsinperil.org. The foundation was started after a personal loss of the founder and its mission statement is to assist doctors in obtaining refunds from electronic medical records manufacturers for products that do not work as advertised.

The state of healthcare IT in the Middle East

Sun, 16 Mar 2008 17:05:34 +0000

A reader, Rami Yousef, wrote me yesterday asking the following: What are your views on the healthcare industry in the Middle East, are they moving in the right direction in converting their clinics to e-clinics? Since I live and work in the USA I know this market well but don’t really have much of an idea about how the Middle East healthcare IT industry is faring. I know I have many readers around the world, and based on Google Analytics, some of you are in the Middle East.

Dr. Ankush’s Essential knowledge for entering the healthcare field

Thu, 13 Mar 2008 22:09:09 +0000

Many of my friends and readers of my other blogs (like my Architecture one) often ask me where they can get information about “how to get into healthcare.” As the IT field has grown in many verticals, healthcare among them, specialization provides more job security and better opportunities. Dr. Ankush Shinde sent me this note a little while ago: I am regular reader of your blog. Please find <a href="[attached document][2]{#p419} it contains essential comprehensive references for healthcare information technology professionals.

Insurer finds EMRs won’t pay off for its doctors

Thu, 13 Mar 2008 21:57:35 +0000

AMNews reports: The Massachusetts Blues believes that the return on physicians’ investment doesn’t warrant buying the technology as part of its bonus programs. One health plan has come to a conclusion that many physicians already have reached: The financial benefits of office-based electronic medical records systems are not worth the cost to doctors. Relying on information from past studies, including an American Medical Association estimate that doctors see only 11 cents of every dollar saved through the use of information technology, BlueCross BlueShield of Massachusetts recently announced that it has decided not to require physicians to install an EMR to participate in its bonus program.

Guest Article: IT Security and Record Management in Healthcare

Thu, 13 Mar 2008 19:49:31 +0000

Many of my readers have been asking about security, privacy, and HIPAA these days. I thought I would reach out an expert — Dr. Zachary Peterson. Zachary is a Senior Security Analyst at Independent Security Evaluators a computer security consulting firm in Baltimore, MD. Dr. Peterson earned his Ph.D. in Computer Science at The Johns Hopkins University, where his dissertation was on new technologies to meet regulatory compliant storage system. He also has a Masters in Security Informatics and a Masters in Computer Science.

WhoIsSick.org collaboratively collects symptoms and locations

Thu, 13 Mar 2008 11:06:43 +0000

Ed from WhoIsSick.org wrote me about his new site: It is Web 2.0/User generated content meets Healthcare through a very simple Google Maps interface. Given the relatively slower adoption of internet and “web 2.0′ technology by much of the healthcare industry (aside from Revolution Health and a few select others), we set out to create a simple, user-friendly, and valuable website for the average consumer. I thought you may want to check out some of the new features we added to the site.

TrustRex for online, free doctor + patient communications

Thu, 13 Mar 2008 11:02:12 +0000

A reader recently wrote me: Have been reading your blog off and on for a while. I recently came across a site called www.trustrex.com when researching another issue. Apparently allows patients to register online with any doctor that is registered with the site. After that, patients can apparently communicate securely with the doctor after logging in. Thought it might be something worth checking out. The online registration alone is great for anyone whose had to fill out that paperwork while sick or with kids running around.

Guest Article: Dr. Olson asks if we’re looking at healthcare IT to solve the right clinical problems

Sun, 02 Mar 2008 18:26:30 +0000

A physician friend of mine, Dr. Richard Olson (“Rich”) of Gainesville, GA, and I often discuss healthcare IT issues over e-mail. He is a thoughtful, caring surgeon in private practice who has been involved in health IT issues for decades (as a consumer of them and on multiple selection committees for products at various hospitals). He definitely knows his stuff. Recently Rich sent me a note wondering about whether or not the years of healthcare IT that has been applied was in the best manner to help patient outcomes and improve clinical care.

Interesting video on paperless healthcare

Sun, 02 Mar 2008 17:56:24 +0000

Robert Pierce, a Healthcare IT Guy reader and fellow healthcare technologist, recently sent me the following note: I attended a breakfast at HIMSS put on by Allscripts at which Newt Gingrich spoke. Before Newt came to the mike they aired a video that’s pretty interesting I think; makes the point with precision and power even though it’s a vendor product (understated). Though I was slightly offended as a health professional by the over-the-top focus on medical errors, it’s worth viewing as a reminder of why we need to get paper out of medicine.

100 Search Engines and Tools for Medical Self-Diagnosis

Wed, 27 Feb 2008 13:39:22 +0000

Amy Quinn just pointed me to e-Second Opinions: 100 Search Engines and Tools for Medical Self-Diagnosis. Very nice list of tools and worth checking out. Thanks, Amy.

What Doctors Think — useful Physician surveys

Wed, 27 Feb 2008 02:02:07 +0000

A friend of mine sent out this link to WhatDoctorsThink.com, which “provides survey results as a public service to the medical community to stimulate innovation and improve the quality and economics of healthcare.” The one I found most useful, since I’m a tech guy, was the EMR and HealthVault (PHR) Survey Results. Interesting bedtime reading.

CCHIT info and Free Software Advice for Medical/Health industry

Wed, 27 Feb 2008 01:51:26 +0000

I just ran across the Medical Software Advice, which bills itself as a free resource that helps physicians find the right EMR, medical billing and practice management software for their practices. They have a nice article, “Should CCHIT Influence Your EHR Selection,” that I think everyone looking at CCHIT certification should read about. Very timely and useful advice.

HITCHtv Beta – health IT TV land

Tue, 26 Feb 2008 11:53:47 +0000

HITCHtv is a new site with healthcare IT videos and multimedia. Worth checking out.

HL7 Primer for non-techies

Mon, 25 Feb 2008 02:03:02 +0000

One of my readers wrote me today: Shahid, I’ve been following your blog for a few months. I was wondering if you know of a HL7 primer for beginners (non-technologists)? I figured others would want an answer to this question, so I decided to reply publicly. A very good “starter kit” for HL7 are Neotool’s Whitepapers like Why Do I Need an HL7 Interface Engine?. Definitely [register for their free HL7 Reference Guide][3], too.

HealthRanker social media health site beta launched

Sun, 24 Feb 2008 13:59:15 +0000

Israel Lagares wrote me recently about the beta launch of his new site www.healthranker.com, which is a social media news/voting site dedicated to health and wellness. He said he created it because he got tired of the larger social media sites not giving enough love to the healthcare sector. Good work, Israel — we could use more sites like these.

Neat little wallet-sized “Smart PHR” card

Tue, 19 Feb 2008 14:16:11 +0000

The health IT industry has been working on personal health records (PHRs) for a while and I suspect it will take years before they really take off in a big way. PHRs are likely not to become prevalent at least until the ambulatory care market starts to recognize their utility and doctors convince patients to use them. I just ran across this new device: MiCard. MiCARD is the size of a credit card (just a bit thicker) and you load your medical record onto it.

Locking down browsers in healthcare settings to prevent staff misuse

Mon, 24 Dec 2007 14:29:20 +0000

More and more healthcare applications are being re-platformed to run as web applications. While it’s good for ease of deployment, this means that staff that had no business using web browsers before now have valid work reasons to run browsers. This may lead to “unofficial” use of office browsers for non-healthcare use such as shopping, reading the news, playing on FaceBook, or other types of misuse. While some misuse may be acceptable because all it does is waste time, other types of misuse like downloading files, playing music online, etc will cause viruses to enter the network or may take up valuable network bandwidth.

LinuxMedNews interviews new Medsphere CEO Michael Doyle

Tue, 16 Oct 2007 15:21:08 +0000

Those of us pursuing open source in healthcare IT always like to keep our eyes on what’s going at Medsphere and WorldVistA. It was great to see this interview with the new CEO of Medsphere. These were my favorite questions: LMN: It has been said that: “Medsphere could have been the “RedHat of Medical IT” that our community desperately needs. Instead they are the “Enron of Medical IT”.” because of the lawsuit against its founders Scott and Steve Shreeve.

Guest Article: Rich Internet Applications for Improved Healthcare App User Experience

Mon, 15 Oct 2007 14:32:16 +0000

I’m a huge fan of thin-client systems but the thinner the client, the less functionality it seems to support. A pretty smart colleague of mine, François Jean, is an engineer at Cardinal Health working on a bed side information system and he has some suggestions for healthcare IT systems that need to stay thin for deployment but remain just as functional as a desktop app. François has more than 10 years of experience in the computer science field and is interested in simplifying and improving the quality of software for a faster time to market while maintaining a stellar customer experience.

Request for Introduction to Healthcare Technology/IT Resources

Fri, 12 Oct 2007 14:10:26 +0000

As a health IT blogger I’m often asked about books and articles that can introduce the general topic of technology (and IT) in healthcare. One of the nicest free resources is available at NIH. It’s called HTA 101: Introduction Health Technology Assessment. It’s worth reading much of the document but there’s a section on fundamental concepts and issues that’s really useful. It’s not specific to IT and the document is more about assessing technology than using it but it’s a good introductory document.

Guest Article: What Jenny McCarthy can teach us about behavior change and data

Tue, 09 Oct 2007 10:16:59 +0000

As all you probably already know, I’m a follower of healthcare startups and am a sucker for new ideas and smart people. I was recently introduced to Joshua Rosenthal, Ph.D. and when I found out he’s a Fulbright recipient whose work focuses on behavior change I knew I had to get him to share his thoughts about how IT can help. He recently worked with a small team creating clinical facts systems and data architectures for a disease management company with about 20 million members and a multi-dimensional database for a large health plan, tying together disparate data sources (service center calls, web sessions, claims, lab, Dartmouth Atlas, census, consumer/commercial marketing data, etc.

Microsoft releases new PHR

Thu, 04 Oct 2007 15:25:30 +0000

Microsoft just unveiled HealthVault, the first personal health record (PHR) designed with an ecosystem in mind. I created mine online and it’s a bit sparse but a good start. Anyone who’s doing anything in the consumer space needs to pay attention to HealthVault because Microsoft threw down a pretty good gauntlet that Google will be matching soon. HealthVault has basic record management and simple document management capabilities. It would be great if practice management systems and hospital systems started to connect and share information with HealthVault to make it even more valuable.

Personalized drug safety alerts

Thu, 27 Sep 2007 23:39:11 +0000

Medication errors account for a larger portion of deaths than they should. As part of my work for various firms I’ve been involved in designing, architecting, and installing drug safety systems in hospitals and IT systems. Reducing medication errors is a big goal for everyone these days but it’s not easy for a patient to do much about it on their own. Until now. I was pleased to learn about iGuard.

Professional Social Bookmarking can provide real value

Sun, 23 Sep 2007 11:14:48 +0000

I got a note recently from Scott McQuigg, CEO of PeerClip, about their new social bookmarking tool. At first I thought “oh, no – not another ****bookmarking site.” But, I’m a sucker for any new startup in the Health 2.0 space so I took a look. It is one of the first bookmark sharing sites I’ve seen designed for specifically for physicians; I thought it was a great idea. Today, all social bookmarking tools are peer generated content.

Hospital Rankings Visualized

Sun, 23 Sep 2007 10:46:49 +0000

Naoum Issa at Medical Resource Group showed me a neat little tool at NetDoc which is basically a mashup of Google Maps and HHS hospital database. It uses publicly available data from the Department of Health and Human Services, and displays a summary of the information on a GoogleMap. Although the information shouldn’t be see as canonical, it’s a quick and easy way to access hospital quality data by locale, and the ability to drill down for more detail if necessary.

Demonstrating Open-Source Healthcare Solutions (DOHCS)

Fri, 14 Sep 2007 10:48:27 +0000

Fred Trotter sent me a note about the second annual “Demonstrating Open Source Health Care Solutions” (DOHCS) Open Source health care conference. It will be held on February 8, 2008, prior to the 6th Annual So Cal Linux Expo and will allow health care professionals to learn about opportunities to implement Open Source software solutions in their field. They are requesting: If you’ve already implemented an Open Source solution in a health care environment, please consider sharing your experiences with us.

Management 2.0

Fri, 14 Sep 2007 01:16:08 +0000

In a nice interview with Gary Hamel, Allan Alter at CIO Insight writes: The efficiency-focused management model has run its course, says strategist Gary Hamel. To see the future of management, look to the Internet, open source, free markets and democratic institutions. It’s a good article. Some other interesting snippets: Has management as we know it reached the end of the road? Strategy expert Gary Hamel thinks so.

Make sure your online SaaS vendors are appliance-capable

Sun, 02 Sep 2007 12:26:25 +0000

We’ve all been hearing pundits rave about how SaaS (software as a service) is the next wave of technology (mainframes, desktop PCs, and client/server systems being earlier waves). I certainly agree that software running “in the cloud” is a great idea for lots of reasons. However, companies in general, and healthcare enterprises particularly, need to be careful putting any mission-critical data into the hands of other firms no matter who they are.

Key Health IT opportunity: Medicare Says It Won’t Cover Hospital Errors

Sun, 26 Aug 2007 12:47:20 +0000

Last week the NY Times and others reported that Medicare will stop covering expenses incurred by hospitals for what the agency considers as errors: In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars. Assuming the rules get enacted as expected, this is a major opportunity for health IT firms to jump in with solutions.

Microsoft Health Common User Interface (CUI) Guidance and Controls

Wed, 08 Aug 2007 16:55:59 +0000

Microsoft’s been tying to make some major inroads into healthcare IT (some impressive, others that are a little “me too”). They are strong in the office automation and general computing space in hospitals but weak in the healthcare-specific vertical and clinical areas. One of the areas that Microsoft’s always been strong is supporting the development community and they’re starting to make some good progress in health IT (specifically health not the just IT part).

Health IT Blogs Visualized

Wed, 08 Aug 2007 02:17:26 +0000

Ryan Byrd over at [healthTech.accordingtome.com][1] has a great picture of the HIT blogosphere. Here’s how he described what he did: What does the healthcare blogosphere look like? That is, how are all the healthcare IT blogs interconnected? … I wrote a quick program that extracted the blogs listed there and for each of them, I spidered the first page for links and checked to see if those links linked back to the original 50.

E-mail good for patients, not so much for docs

Sun, 29 Jul 2007 00:11:54 +0000

There was an interesting article in the Portland Business Journal a few weeks ago which intimated that as physicians increase their use of e-mail with patients, their incomes may decline: For physicians’ offices, e-mail between patients and providers may prove a mixed blessing. Patients who use e-mail to communicate with their medical providers are apt to visit the doctor’s office less and are also less likely to phone the doctor’s office, according to recent data from the Kaiser Permanente Center for Health Research.

If you can’t repeat it, don’t bother automating it

Mon, 23 Jul 2007 13:30:58 +0000

There’s been plenty of discussion in both literature and general media about how most software projects fail. There are plenty of reasons for failed projects: from inadequate requirements gathering to poor project management to plain incompetence. Some of the problem starts at the C-Suite where projects are actually identified and initiated — for asking to automate (presumably with software) something that maybe has no business being automated. My simple advice to most CEOs and CIOs about project management starts with a question: can you methodically and manually repeat the thing you are trying to automate?

Guest Article: Safeguarding critical patient information

Mon, 16 Jul 2007 15:27:28 +0000

I’ve been researching service continuity for patients in Healthcare organizations recently. I ran across a company, Marathon Technologies, who focuses on fault tolerance in IT infrastructures and I found it interesting that they were targeting tools necessary to provide care for patients. I invited Mr. Joost Verhofstad, Director of Healthcare Solutions at Marathon, to talk a bit about what they do and how they safeguard critical patient information. I requested that he help prescribe preventative high availability solutions to ensure that unplanned system failures never come between patients and their healthcare needs.

Research questioning EMRs effectiveness mounts

Wed, 11 Jul 2007 00:17:10 +0000

A buddy of mine, Bob Burns at 5th Quadrant, sent me a couple of links questioning the clinical effectiveness of EMRs; the links were just adding to several others reports that I’ve seen recently. I’m not sure I agree with all the findings, but the direction in which the winds are blowing is clear: be wary of EMRs that promise better clinical outcomes. Electronic Health Record Use and the Quality of Ambulatory Care in the United States (from the Archives of Internal Medicine).

HIPAA audit: The 42 questions HHS might ask

Thu, 28 Jun 2007 15:26:49 +0000

HHS conducted it’s first-ever HIPAA audit in March. ComputerWorld reports on the The 42 questions HHS might have asked. It’s worth watching closely. Source: Fred Trotter through a link he saw on David Harlow’s healthcare law blog.

Top healthcare and medicine blogs

Sun, 24 Jun 2007 13:31:41 +0000

Tim Gee wrote recently about eDrugSearch.com’s Healthcare 100 ranking of the world’s top English language blogs in health care and medicine. I was happy to see quite a few healthcare IT blogs (including this one, Tim’s, and a number of others that are in the HITSphere). The algorithm eDrugSearch.com uses is a mixture of Google PageRank, Bloglines Subscribers, Technorati Authority Ranking, and their own proprietary point system.

What’s driving the ‘Driven’ approaches in software development?

Fri, 15 Jun 2007 12:57:48 +0000

A buddy of mine, Andy Glover, recently sent me a link to an SDTimes article (see page 3) which asks the question “are there real differences between methodologies, or is it just marketing?”. The article by Jennifer DeJong is pretty good but the pleasantly surprising part was that she picked my “Resume-driven Development” post. She wrote: Another variant of the “driven” theme is resume-driven development, or RDD. RDD is all about choosing a language not because it’s well suited to a particular project, but because acquiring skills in that language will help a developer bolster his or her resume.

Google planning a PHR?

Fri, 15 Jun 2007 12:23:45 +0000

I’ve personally thought for months that Google was working on a medical search portal and mini PHR and some of those thoughts were confirmed when Fred Trotter sent me this link. Fred noted that Google became more specific regarding its healthcare plans and, in what should be surprise to no one, it sounds like they are planning a PHR.

Telemedicine in a box

Sat, 09 Jun 2007 22:50:13 +0000

A buddy of mine told me about this product which seems to take the pain out of technology integration for telemedicine needed in remote healthcare visits. I like the idea a lot because it combines video, audio, and healthcare diagnostics into a single special purpose device with custom software to tie it all together. Here’s what they say about the offering: Televisit™ is a managed network that provides healthcare professionals with Telemedicine services that are quick to set up, easy to use, and require minimal capital investment.

Disaster time prescription records

Sat, 09 Jun 2007 17:17:42 +0000

ICERx.org (In Case of Emergency Prescription Database), an online resource that provides licensed prescribers and pharmacists caring for disaster victims with secure access to a patient’s comprehensive medication history, has just been lanunched. ICERx.org (www.icerx.org) is a public service initiative created by AMA, Informed Decisions, the National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA), RxHub and SureScripts, as well as state Medicaid and other government agencies.

Online Social Networking for Physicians

Wed, 06 Jun 2007 19:50:54 +0000

Dr. Subrahmanyam Karuturi has put up a nice list of Online Social Networking Sites for physicians. I had hear of Sermo a one or two others but the list is actually longer than I expected it to be. I wonder if anyone’s done any research on the value of these networks to physicians and see where there is more demand. Online sites like these are so easy to create these days that if we can get our tired and overworked physicians online to give them some relief it would be a good thing.

Center for American Progress’ Health IT Report

Wed, 06 Jun 2007 19:37:58 +0000

The Center for American Progress released a new report about how to improve the American health care system through the use of health IT. Nothing ground-breaking but there are some good ideas expressed in a way that’s easy for policy officials to understand the importance of IT in healthcare. Of course, there’s little mention of the real barriers to use of IT in the healthcare industry, which is poor or non-existent incentives for practitioners.

What if medical care came with a 90-day warranty?

Thu, 17 May 2007 17:30:48 +0000

Geisinger Health Systems is serious about improving the quality of care. This was in the New York Times today: What if medical care came with a 90-day warranty? That is what a hospital group in central Pennsylvania is trying to learn in an experiment that some experts say is a radically new way to encourage hospitals and doctors to provide high-quality care that can avoid costly mistakes.

Disruptive Innovations in Health and Health Care Competition – Solutions People Want

Tue, 15 May 2007 00:54:43 +0000

I got a note this morning about $5 Million being made available to “Support Ideas That Transform Markets and Empower Consumers.” Here’s the story: “Disruptive Innovations in Health and Health Care” is an open source competition to identify ways in which the health and health care marketplace can offer services, tools and choices that consumers want-but are currently out of reach because of cost, complexity or because the right idea hasn’t come along.

Consumers and Health Information Technology: A Top 10 List

Tue, 15 May 2007 00:36:18 +0000

In honor of National Health IT Week (May 14 – 18), a week-long forum dedicated to increasing the awareness and impact of IT for healthcare, QuadraMed compiled a list of the Top 10 reasons consumers should care about medical technology. All the healthcare IT (HIT) vendors are out in force this week pushing their wares but I thought QuadraMed’s focus on why consumers should care was unique. Consumers and Health Information Technology: A Top 10 List

Free tool to help identify iPods, USB sticks on the network

Tue, 08 May 2007 20:54:11 +0000

I’ve written previously about PodSlurping and portable storage devices being a security hazard on our healthcare networks. I ran across this tool called EndPointScan. GFI have just released this online scanner, which is basically a free tool that can show which portable storage devices have been and are being used on an organization’s network, where on the network they’re used and by whom. If you’re in the information assurance or security group in your department or enterprise you owe it to yourself to get a tool like this so you’re not caught off guard.

EHRs Fix Everything – and Nine Other Myths

Sun, 06 May 2007 13:39:46 +0000

I read this article recently published by American Academy of Family Physicians and found it quite useful. As a health IT professional, I also talk about many of the ideas written up in the article but perhaps coming from a fellow physician (the author an MD), it will mean more to other physicians considering EMRs and EHRs. Here are myths the article debunks (along with some of my own comments):

WorldVistA EHR CCHIT Certified

Tue, 01 May 2007 14:59:00 +0000

I wanted to thank Fred Trotter for sending me this note yesterday: Now you can download and use an FOSS EHR under the GPL that is CCHIT certified. The days of the proprietary EHR systems are OVER. I love Fred’s enthusiasm about open source software in healthcare, it’s definitely the direction of the future. While CCHIT certification doesn’t actually improve a product or make it any more applicable to a particular client, it’s great to see that a free and open source solution can no longer be derided as “not being certified” by other vendors.

Change management and versioning of services

Mon, 30 Apr 2007 13:20:23 +0000

We’ve been having a nice discussion on the management of services and how services should be versioned on our Microsoft Architect MVP discussion list. This morning I saw a note from Martin Fowler pointing to an article on Consumer-driven Contracts. The article is definitely worth reading, and here’s the abstract: This article discusses some of the challenges in evolving a community of service providers and consumers. It describes some of the coupling issues that arise when service providers change parts of their contract, particularly document schemas, and identifies two well-understood strategies – adding schema extension points and performing “just enough” validation of received messages – for mitigating such issues.

IT implications of Wal-Mart’s 400 new in-store clinics

Fri, 27 Apr 2007 21:35:31 +0000

Reuters reports that Wal-Mart is planning to open 400 in-store clinics in the next few years, climbing to about 2000 within the next 7 years. They said that Wal-Mart plans to contract with local hospitals to provide the personnel and service and that made me curious. What are the IT implications and opportunities here? Could Wal-Mart become a pseudo-RHIO in some areas since it will need to have some connectivity with hospitals, labs, and other ancillary service providers?

Microsoft’s Internet Service Bus

Thu, 26 Apr 2007 00:00:06 +0000

We’ve probably all heard about the Enterprise Service Bus (ESB) but I’ve been playing with Microsoft’s new Internet Service Bus and like the idea. Instead of installing an ESB within your own firm (which is not a trivial job), you can use a publicly hosted service bus infrastructure managed by Microsoft. With a good identity federation architecture, the security is “good enough” for most uses and you should check it out.

Privacy preserving data mining

Thu, 12 Apr 2007 18:22:31 +0000

I love all things Google, especially Google Talks where they have smart guys presenting tech topics to Google staff and they record it for the rest of us to view later. Recently I ran across this video on privacy preserving data mining. Seems like an esoteric topic, but it’s important to us all in healthcare for sharing data without revealing private information. The speaker it talking about data mining for internet traffic but all the algorithms are useful in our industry, too.

How I’d Hack Your Weak Passwords

Mon, 02 Apr 2007 15:40:46 +0000

A recent posting at One Man’s Blog offers tips for choosing passwords by showing how simple it is to crack some passwords. Here’s a quick excerpt from his blog:

How to do positive patient ID in consumer and kiosk settings

Mon, 19 Mar 2007 20:57:03 +0000

I often get asked about how to positively identify a patient in a consumer or kiosk setting (shared computer environments also). For example, if a patient comes in and you want to hand them a computer to do some data entry with, how would be able to positively identify the patient as a specific person? And, you need to be able to do this without “logging them in” or require them to remember a password.

HL7 library for Ruby Released

Mon, 19 Mar 2007 20:39:44 +0000

Mark Guzman over at Tech Addict just announced the 0.1.23 release of an HL7 parser for Ruby. I’ve been doing a bunch of Rails stuff lately and this should come in handy when I need HL7 parsing. I haven’t tried it out yet, but here’s what Mark said is in there: Flexible parsing support MLLP support Provides a simple DSL (domain specific language) for defining segments (Ruby style) Allows for arbitrary manipulation of segment data Automatic segment ordering (via sort) Familiar Ruby Array/Enumerable semantics How to get it:

A free Ad-based EMR

Sun, 18 Mar 2007 19:42:41 +0000

I wanted to call your attention to Dr. Scott Shreve’s posting about Practice Fusion and ad-driven revenue. Having built out half dozen EMRs in my career, it’s good to see a company like Practice Fusion giving adware a try — I don’t think they have anything to lose. I hope they can succeed where other EMRs have failed (or at least not done so well). The technology behind EMRs is embarrassingly easy to create nowadays — most EMRs are just simple databases that act like electronic typewriters and simple filing cabinets.

Helping Health IT firms commercialize their offerings

Sun, 18 Mar 2007 19:08:23 +0000

I have been working closely with Larta www.larta.org and the NIH funded Healthcare IT companies they are assisting with commercialization. These companies have some very interesting technologies and with the right guidance and help, have tremendous market potential. Larta will be conducting a workshop in Washington DC and on March 29 and 30, 2007, these NIH funded Healthcare IT startups will pitch their technologies to an audience of mentors and advisors comprising of investors, industry personnel and consultants.

Open Source data mapping and transformation tool from NIH

Thu, 08 Mar 2007 23:12:10 +0000

My friend Jeremy Hulick recently wrote to me about NIH’s caAdaptor tool, an open source product he learned about at the recent CaBIG conference. Here’s how the authors describe it: caAdapter is an open source tool set that facilitates data mapping and transformation among different kinds of data sources including HL7 v2 and v3 messages, Study Data Tabulation Model (SDTM) data sets, object models and data models. For HL7 v3 messages, it possesses the capability to perform vocabulary validation by integrating with NCICB caCORE components and provides web service access for easy application integration.

How much do you know about healthcare in America?

Fri, 02 Mar 2007 18:47:35 +0000

One of the most common presentations and lectures I do at companies is an “Introduction to Healthcare IT” (Health IT 101). Some of the items I try to cover include how the healthcare industry in the USA operates because inevitably our IT systems are limited in functionality because of our business structure. Nainil Chheda, who posted a guest article on NHIN last month, sent me his “Introduction to Healthcare in the USA” presentation that he’s written for some briefings he’ll be doing outside the USA.

Excellent tips, tricks, and advice for those going to the HIMSS Conference

Thu, 15 Feb 2007 01:00:46 +0000

Tim Gee does some wonderful posts on medical devices and interoperability. Like any good blogger, he’s a good writer and he really knows his subject matter. Recently, he wrote a series of articles on how to get the most out of your trip to the Annual HIMSS pilgrimage. If you’re going and want to get some tips, tricks, and advice, check out: Getting the Most from HIMSS – Providers HIMSS Tips for Vendors – Competitive Intelligence HIMSS Tips for Vendors – Closing Sales Getting the Most From HIMSS By the way, if you’re a vendor who’s exhibited in the past but is not exhibiting this year, can you drop us some comments about why you might not be attending this year?

Tolven Healthcare Innovations has ready to run open source healthcare apps

Thu, 15 Feb 2007 00:54:53 +0000

Check out Tolven Healthcare Innovations — they’ve got this open source software (language from their website): An electronic Personal Health Record solution (ePHR) that will enable consumers to record and selectively share healthcare information about themselves and their loved ones in a secure manner. An electronic Clinician Health Record solution (eCHR) that enables physicians and other healthcare providers to securely access healthcare information collated from any number of trusted sources relating to an individual patient in a structured and easily accessible way.

HIMSS Blogger Meetup Date, Time, and Location Established

Sun, 11 Feb 2007 03:23:41 +0000

After a number of e-mails and suggestions we’ve got general consensus on date, time, and venue for the meetup: Date: Sunday, February 25, 2007 Time: 08:00 PM (right after the HIMSS Reception) Location: Mulate’s (Cajun restaurant and bar located right across from the convention center) — thanks to Tim Gee for the arrangements Here’s who’s signed up so far Click here to register

Health Wonk Review #25

Thu, 08 Feb 2007 17:00:47 +0000

Health Wonk Review #25 is up at David Harlow’s Health Care Law Blog. It’s a fun review of some of this week’s best healthcare blogging.

Daylight Savings Time change this year may cause healthcare transaction hiccups

Wed, 07 Feb 2007 15:39:45 +0000

This article was initially posted at HISTalk. However, the issue is important and I’ve received good feedback on the readiness of medical devices from Tim Gee of Medical Connectivity and I wanted to share his thoughts here as well. As we all probably know by now, this year Daylight Savings Time (DST) starts on March 11 instead of in April. Daylight-saving time has usually started on first Sunday of April and reverted to standard time on the last Sunday in October.

2nd Annual HIMSS Blogger Meetup taking shape

Mon, 05 Feb 2007 03:13:48 +0000

We’ve got about 20 people signed up for the New Orleans meetup (click here to register or here to see who’s signed up so far). Looks like based on all the current feedback, Sunday night before the conference starts looks like the best time. Neil and Tim are helping to come with a venue and I’ll be tracking down last year’s attendees to see if they’re interested in dropping by. Here are some other HIMSS Blogger ideas we’ve come up with:

My thoughts on AHIMA’s new Healthcare Privacy, Security certification

Sun, 04 Feb 2007 15:25:14 +0000

Jennifer Lubell at Modern Healthcare Online recently posted her nice article on AHIMA’s new privacy and security certification. She writes: In April, the American Health Information Management Association will offer a new certification aimed at credentialing the healthcare privacy and security industry. AHIMA essentially combined its Certified in Healthcare Privacy and Certified in Healthcare Security certifications, said a spokeswoman for the organization. The certification aims to reflect advanced competency in designing, implementing and administering comprehensive privacy and security protection programs in all types of healthcare environments and settings.

Recap of 3rd Nationwide Health Information Network Forum

Thu, 01 Feb 2007 01:37:50 +0000

On Thursday, Jan. 25 2007, Department of Health & Human Services hosted the 3rd Nationwide Health Information Network (NHIN) Forum: Prototype Demonstrations and Business Models. I wasn’t able to make it, but one of our colleagues, Nainil Chheda, did attend and was kind enough to do a recap for us. Nainil (http://www.nainil.com) is a Knowledge Research Specialist at eClinicalWorks where he is responsible for ensuring the overall development of the product in compliance with the various healthcare standards (CCR, CDA) and certifications (CCHIT).

NIH Lecture: Computation with Information Described in Natural Language (Feb 8)

Wed, 31 Jan 2007 02:13:27 +0000

NIH’s Biomedical Computing Group is putting together a lecture on natural language computation (not to be confused with natural language processing). If you’re interested in attending, drop me a comment here and we can meet up there. The speaker, Dr. Lofti A. Zadeh, prepared the following abstract (see poster): What is meant by Computation with Information Described in Natural Language, or NL-Computation, for short? Does NL-Computation constitute a new frontier in computation?

Jasypt: Java encryption library that eases encryption of database fields too

Tue, 30 Jan 2007 15:46:47 +0000

If you’re writing healthcare apps in Java, take a look at Jasypt. Especially if you need to encrypt data in your databases. Here’s how the authors describe it: Jasypt is a java library which allows the developer to add basic encryption capabilities to his/her projects with minimum effort, and without the need of having deep knowledge on how cryptography works. Features: Provides easy encryption tools for little adoption effort.

Improving Patient Communication often leads to improved healthcare

Tue, 23 Jan 2007 15:00:49 +0000

I recently ran across Emmi Solutions (www.emmisolutions.com), which I was fascinated to learn was co-founded by a surgeon and a computer game designer (not exactly a common combo). What I liked about Emmi was that it facilitates physician-patient communication by providing “prescription-strength” multimedia programs to help patients understand what to expect before, during, and after a surgical or invasive medical procedure. As most of us who’ve been in this industry for a while intuitively get, the more a patient knows and understands about their care providers, their diagnoses, and their procedures, the better the patient’s overall health is likely to be.

Adding full-text searching to Relational Databases

Mon, 22 Jan 2007 16:20:16 +0000

Relational databases like ORACLE, SQL*Server, and MySQL are great at storing structured data in rows and columns and managing relationships across tables. Relational database are also more write-friendly than read-friendly (like searching). What that means is that vendors and developers often structure the tables and columns more to make it easy for them to write data into than for users to read data out of (because users are always more creative than we think they are).

Resume Driven Development (RDD)

Fri, 19 Jan 2007 15:33:03 +0000

It always amazes me when I find new or even seasoned managers that haven’t come across a situation where programmers wanted to use tools, techniques, or technology to improve their resume instead of solving the customer’s problems. This concept, which I call RDD (resume driven development), is very real and it’s actually a fairly widespread problem. In fact, RDD is so prevalent these days that people will actually choose Java over Perl because “Perl will not help my career”.

Developing your own master person index using open source tools

Wed, 17 Jan 2007 05:18:23 +0000

There are several types of directories that are useful in healthcare settings; the first is a directory of users and Microsoft Docmain Controller (DC), Active Directory (AD), and LDAP are the most common solutions. DC, AD, etc all help manage a list of users, their roles, and other identity management functions within an enterprise. Another common directory is a master person or master patient index (MPI). MPIs are very useful because it gives a single view of the patient (customer) population within an enterprise.

Platform for building healthcare fraud detection applications

Mon, 15 Jan 2007 15:05:20 +0000

I ran across Picalo, an open source fraud detection platform, and thought it might be a great solution for those of us looking to build our own fraud detection systems in healthcare settings. Here’s how the authors describe it: Picalo is a data analysis application, with focus in fraud detection and data retrieved from corporate databases. It is also the foundation for an automated fraud detection system. Picalo is currently focused on data analysis for fraud and corruption detection.

Single sign on (SSO) solutions in healthcare

Sun, 14 Jan 2007 18:13:17 +0000

Based on my recent discussions with numerous CIOs, they each mention that SSO is something that’s on their radar screens as an important or high priority requirement. Given that most users deal with multiple IT systems during the day and they’re getting tired of re-authenticating themselves for each system, it’s understandable. While the commercial vendors already tout their own (pretty good in some cases) solutions I thought I’d bring some of you up to speed on one open source solution that you may not be aware of: the Central Authentication System (CAS).

Try Acrobat Connect for Healthcare Collaboration

Thu, 11 Jan 2007 19:19:19 +0000

Adobe recently announced the release of its Acrobat 8 product line. Acrobat (and the associated PDF format) is in heavy use within the healthcare industry because of it’s ability to manage paper documents in electronic format with high fidelity. One of the important new features of Acrobat 8 is Acrobat Connect which allows users to start a Web conference to collaborate on any kind of document (not just PDFs). What’s great about Acrobat Connect (which I’ve used recently) is that it has the ability to easily collaborate on medical records, diagnosis charts, simultaneously view lab reports, etc.

Healthcare Blogger and Reader Meet-up at HIMSS in New Orleans

Mon, 08 Jan 2007 02:48:11 +0000

Your friendly neighborhood healthcare bloggers are preparing for another meetup at the HIMSS ‘07 conference next month in New Orleans. Last year’s meetup was a smashing success so we’re looking forward to another great gathering this year. If you’re a healthcare blogger who’d like to meet other bloggers/readers or a reader that would like to meet their favorite bloggers, we have an automated registration database available to express your interest.

Open Source EMR and Practice Management Software Appliance

Sun, 07 Jan 2007 01:38:08 +0000

If you’re looking for a simple and fast way of trying out free EMR and practice management software, check out the OpenEMR 2.8.1 Virtual Machine Appliance. All you need to run it is a computer with VMware Server (freely available). It comes complete with an operating system and all the software you need. Here’s how the authors describe it: This is a comprehensive Open Source Medical Practice Management Software Appliance.

Is your Health IT Network NSA-secure?

Sat, 06 Jan 2007 09:12:12 +0000

The NSA’s unclassified 60 Minute Network Security Guide is a great way to check that your network security is up to par with the nation’s pre-eminent spy agency’s guidelines. Check it out and see if your network measures up — leave some comments here to tell us what you think about the guidance provided.

Medgadget Medical Blog Award Poll is open

Fri, 05 Jan 2007 23:47:06 +0000

A few readers were kind enough to nominate my blog for the MedGadget Medical Blog Award in the Best Medical Technologies/Informatics Weblog category. Voting is now open; so, if you like this blog, let Medgadget know. Thanks in advance for your support!

Open Source Health Care Summit

Sun, 17 Dec 2006 16:38:11 +0000

The Southern California Linux Expo (SCALE) has announced plans to host an Open Source Health Care summit as part of their upcoming 2007 conference, SCALE 5x. The event will be held on February 9, 2007 at the Los Angeles Airport Westin Hotel. Here’s what they say about it: The focus of this event will be on the use of open-source software in the health care industry. The goal of this event is to foster an awareness of the availability of open-source options to medical organizations, private practices, and hospitals.

Are you protecting Patient healthcare data on discarded equipment?

Fri, 15 Dec 2006 16:21:30 +0000

Given the increase in computer usage to track patient data and that we’re all now going through new cycles of computer purchases (especially with Vista coming soon) discarding older equipment is something we do often. Discarded equipment may include entire computers or just hard disks, thumb drives, and other storage devices. One thing I’ve been discussing with my clients is their strategy for protecting information on discarded devices and it makes sense to review your own policies.

The 2006 Medical Weblog Awards

Wed, 13 Dec 2006 13:21:49 +0000

Medgadget just announced the call for nominations for The 2006 Medical Weblog Awards. If you’ve got some blogs you’d like to nominate, this is your big chance.

Guest Article: Who owns my healthcare data?

Wed, 13 Dec 2006 12:12:00 +0000

Healthcare data ownership is an important issue and I was pleased to run across Pardalis, a company specializing it. Although they don’t focus only on healthcare, they intrigued me because they appear to be a cross between a nascent supply chain Google, eBay, and author-controlled Wikipedia. That is, they claim to be able to increase availability of on-demand healthcare information (which lots of companies are doing) but they provide real-time control over the process of sharing such information to patients and healthcare information producers (which very few allow today).

IT in the House

Tue, 12 Dec 2006 02:24:09 +0000

I was recently interviewed by For the Record magazine about why many hospitals and their CIOs are choosing to bring their IT projects inhouse. Here’s how Elizabeth Roop began the article: It may be too soon to call it a bona fide trend, but there is a change underway within some hospital IT departments, where they are bucking tradition and handling projects internally rather than outsourcing them to vendors or consultants.

Barriers to optimal use of Online Healthcare Apps

Mon, 11 Dec 2006 13:40:16 +0000

I’m a big proponent of software as a service (SaaS), application service providers (ASPs), and related “online application” technologies. Online applications make great sense in healthcare because of the network effect: they are inherently collaborative, they are designed for integration, and easy to install and begin using. However, we’ll have to solve the following problems before we can really call online apps a success in healthcare settings: Application availability offline — online apps are great but what happens if there’s downtime?

Recent postings at HIMSS Live! Blog

Sat, 09 Dec 2006 18:40:31 +0000

I’ve been having fun blogging about the upcoming HIMSS Conference in New Orleans over at HIMSS Live!, the official blog of the HIMSS Annual Conference & Exhibition. In case you’ve been busy doing real work instead of reading all those blog entries, here’s what you may have missed: Why Dr. Enoch Choi attends the Conference. What the Interoperability Showcase is all about. Some of the Symposia geared towards specific audiences.

Guest Article: Comparison shopping for healthcare

Wed, 22 Nov 2006 18:54:42 +0000

I recently learned about Vimo and they intrigued me because they look to be the Lending Tree of healthcare and offer comparison shopping for surgical procedures, insurance, doctors, health savings accounts, and hospitals. They claim to even be able to help consumers negotiate down medical bills they already received. Vimo seems to be a company worth watching because if they can achieve even part of what they plan it could make a direct impact to healthcare consumers.

Open source software for clinical research

Sat, 18 Nov 2006 02:42:22 +0000

A number of my readers have asked me about open source software for clinical research; I recommend taking a look at OpenClinica. From their introduction: It facilitates protocol configuration, design of case report forms, electronic data capture, retrieval, and management. OpenClinica supports HIPAA guidelines, and is designed as a standards-based extensible, modular, and open source platform. It has all the right buzz-words: it’s web-based, written using Java, and is pretty simple to use.

Do micro-job sites offer better jobs?

Wed, 15 Nov 2006 13:00:02 +0000

There’s recently been a steady uptick in new micro-job sites that eschew the “single site fits all” strategy pioneered by Monster.com. Basically, the new niche-oriented sites focus on specific jobs of very specific markets. Well, I bring this up because I ran across Med IT Jobs which is focused on, you guessed it, healthcare IT and medical informatics jobs. While it’s pretty small and doesn’t represent many companies yet, it’s free for a limited time so it’s worth giving it a shot if you’re looking for a job or if you’re an employer with an open position.

Disaster and Emergency Response Systems

Tue, 14 Nov 2006 19:50:32 +0000

All hospitals must have disaster and emergency response systems in place. FEMA’s National Incidence Management System (NIMS) is something that all of us need to be aware of and be able to obtain alerts from and provide information to. I ran across FastCommand, a system which implements the NIMS recommendations, and thought it might be something useful if you don’t have automated systems in place. It has one of my favorite attributes: it’s a web-based solution.

AMIA’s Report on the Secondary use of Healthcare Data

Tue, 14 Nov 2006 01:39:22 +0000

One of my readers, Tim McLung, did me a huge favor recently by answering a question I posed in my recent post Who Owns Your Data? I asked if anyone had seen some work done in this area about data ownership and Tim left a comment pointing to the recently completed report from AMIA entitled “Toward a National Framework for the Secondary Use of Health Data“. Thanks, Tim. The document doesn’t answer all my questions but it’s a pretty good start because there are numerous recommendations.

HIMSS07 Conference Blog Launched

Sun, 12 Nov 2006 22:32:21 +0000

This summer I wrote about HIMSS’ interest in bloggers and blogging and I got a number of positive comments indicating that we’d all be happy to see HIMSS join the Blogosphere. Well, HIMSS has launched their first blog, centered around the 2007 HIMSS Annual Conference and Exhibition in New Orleans. Available at www.HIMSSLive.com, the blog is designed to provide the most current information about the conference along with related healthcare IT news.

Minimizing impacts of change

Fri, 10 Nov 2006 13:03:50 +0000

We all know that an IT organization’s effectiveness is significantly impacted by change. Be it an installation of new hardware, replacement of networking devices, or deployment of software upgrades, change is good; however, everytime something changes there’s a chance for failure because something that worked before may suddenly stop working. Change management strategy is so important that there should be people who are in charge of it in your organization (usually a configuration manager).

Open source personal health records (PHRs) and EMRs

Thu, 09 Nov 2006 12:01:31 +0000

I routinely get asked about online health records that can be private labeled. Here are some of the options for open source health records management: ClearHealth MirrorMed FreeMed OpenEMR VistA Office If any of you out there would suggest others, let me know. While independent EMRs and EHRs functions are useful, the most important feature of any product in this space is its support for interoperability. As such, make sure that whatever you choose has some support for standards:

Neotool adds a valuable voice to the HIT Blogosphere

Thu, 09 Nov 2006 01:04:12 +0000

Neotool is a company I like a lot — they have a great set of products and they know the HL7 space. I’ve met the folks at HIMSS a few times and they’ve always impressed me. Recently I was pleased to find out that they were starting a corporate blog but I was afraid it might be a glossy brochure-style blog. Now, after having read their blog entries for a little while I’m happy to say that they’re adding real value to the HIT Blogosphere — their postings are informative, practical, and provide some great advice without either promoting or advocating their own products.

HHS is looking for input on “Personalized Healthcare”

Wed, 08 Nov 2006 22:06:21 +0000

HHS released an interesting RFI recently. Here’s the summary: Advances in medicine, biomedical science, and technology present opportunities for enabling health care practices to be increasingly patient-specific by taking into account individual differences in health states, disease processes, and outcomes from interventions. Often referred to as personalized health care, the desired impact of these types of health practices is improved effectiveness and safety of medical practices. These health benefits may be manifested through new approaches for predicting disease risk at an early time point, enabling preemption of disease processes prior to full manifestation of symptoms, analyzing the effectiveness of different interventions in specific populations based on their genetic makeup, and preventing the progression of disease and the related complications.

Who owns your data?

Sun, 05 Nov 2006 17:19:32 +0000

Many health plans, hospitals, and even physician offices are putting patient data on the web to help connect to consumers. Many of us are also using service providers (SaaS, ASP, etc) to manage our data. All of these things are great and many of us have thought about the security implications: don’t put things on laptops, keep data from traveling onto USB drives, etc. Lots of thought goes into security these (though probably not as much as is really required).

Technical leadership advice

Sat, 28 Oct 2006 13:44:55 +0000

Many of my younger colleagues often ask about what some of the most important leadership aspects are for technical managers like team leads or architects. There are no hard and fast rules but here are some things I’ve learned over the years: Make Decisions. This is one of the most important aspects of leadership — just making a decision and not analyzing for weeks or months. No amount of evidence or information will ever “be enough” and at some point you’ll need to make a decision.

Advice to NIH Commercialization Assistance Program (CAP) participants

Sat, 28 Oct 2006 13:29:36 +0000

The National Institute of Health Commercialization Program (NIH-CAP), designed to assist promising life science companies bring their technologies to market, is a nation wide program funded by NIH and managed and executed by Larta. The Larta Institute invited me to talk to this season’s group about my thoughts on Healthcare IT, Media, and Training. Here’s what I told them. Healthcare Industry Fallacies I started with a brief discussion about how selling to the healthcare community is very hard but not for the reasons they might think.

Guest article: 10 ways Social Computing is transforming the Healthcare Industry

Tue, 10 Oct 2006 10:29:56 +0000

I stumbled upon OrganizedWisdom.com, a collaborative health information community, a few weeks ago and was intrigued by their premise of allowing people to “share their health wisdom” in an easy to use manner. It combines professional and user-generated health content with social networking technologies to help people make the most informed health decisions possible. I thought it was such a great idea that I reached out to Unity Stoakes, President and co-founder of OrganizedWisdom.

Isn’t it time for the Business Guys to get IT?

Thu, 05 Oct 2006 15:36:58 +0000

For years technology strategists like myself have been working with business folks and C-Suite executives complaining that “you IT guys are too techie” or “you guys just get don’t understand the business”. Many CIOs and architects have been relegated to obscurity because of this perception. In the days when computers were new and technology was not integral to the business, it was ok that the “business guys” were frustrated with the “geeks” if they talked tech but those days are long gone.

The Role of the Web in Hospital Marketing

Tue, 03 Oct 2006 11:24:20 +0000

Forrester’s healthcare and life sciences group has a new report out called The Role of the Web in Hospital Marketing. Here’s the executive summary: Hospital marketers are waking up to the new requirements put on them by the emergence of consumer-directed health plans, the growth of health consumerism, the chronic shortage of nurses, and escalating competition among providers. These execs are moving beyond printed brochures and highway billboards and investing more heavily in their Web sites.

Podslurping: An easy technique to steal Healthcare Data

Sun, 01 Oct 2006 13:10:02 +0000

Back in February I posted about Podslurping and recommended coming up with some policies and procedures to help prevent it. This week Edward Lansink saw that original article and pointed me to his whitepaper called “Pod slurping: an easy technique for stealing data” which discusses the problem with uncontrolled use of iPods, USB sticks and flash drives on your network. Edward’s company has done a nice job capturing the problem domain (which is growing by the minute) and how to use tools like the ones his company makes to get it somewhat under control.

Review of SEIPS Course on HFE and Patient Safety

Tue, 26 Sep 2006 13:10:07 +0000

This summer I wrote about the SEIPS Course on HFE and Patient Safety and that I thought it would be a useful. I was unable to attend it but one of my readers, Satish, did attend it and he was gracious enough to provide a review for us. Satish Duryodhan works as Assoc. VP at Hexaware Technologies Limited and leads Hexaware’s Healthcare Practice. I met Satish during my recent trip to India.

Why Users Don’t Upgrade

Tue, 26 Sep 2006 11:46:23 +0000

Kathy Sierra ponders why it’s so hard to get users to upgrade. If you’re in the software business upgrades mean income and Kathy’s posting is a good summary on what it might take to get users to upgrade.

Consumer and practitioner-friendly Healthcare Search Engine upgraded

Sun, 17 Sep 2006 15:46:49 +0000

Healia, which I wrote about a few months back, is a consumer-focused health search engine which makes it easier to find healthcare-specific information. A new version of the software is being introduced, with the following added features: Enhanced the accuracy and performance of the filtering algorithms Additional filters to allow people to filter by the topic of the document when they submit a disease or drug-related search

The Computer Language Shootout Benchmarks

Wed, 13 Sep 2006 12:34:31 +0000

In case you haven’t seen them before, it’s interesting to look at how different computer languages implementations fare on different hardware. Check them out at The Computer Language Shootout Benchmarks.

Analytics tools are bit more expensive than you think

Tue, 12 Sep 2006 01:41:47 +0000

Many of us run to reporting and analytics vendors because our users scream for reports and we think that if we “just give them a tool” they will be able to make things work and get their own reports. Most of us are finding that not to be the case because we underestimate the effort and time necessary to do analytics and run “user friendly” reporting systems. The main reason we’re surprised is that we believe everything we see during the web analytics demos that vendors present.

Guest Article: Is e-Health An illusion?

Sun, 10 Sep 2006 14:23:53 +0000

Dennis de Champeaux, who runs Ontooo, questioned the viability of eHealth last year. He argued the US has not been able to achieve cost effective quality healthcare (which is eHealth’s key potential contribution) and there is no stakeholder that eHealth can do business with. His post was picked up by an east coast VC – who was sick and tired from pie in the sky eHealth business plans – that he put it on his blog at [www.

Getting small databases like Access and Excel under control

Sun, 10 Sep 2006 11:51:07 +0000

One of the most difficult tasks I have seen my customers grapple with as I advise them on technology strategy for their information management needs is how to get a handle on those pesky Microsoft Access and Excel “files”. While we tend to treat these “documents” as simple file management problems they are far more than that: they are real applications and they are real databases with complete enterprise architecture impacts.

The Benefits of Working With Tech Startups

Sat, 09 Sep 2006 15:25:56 +0000

My friend Eric Spiegel just finished a nice article on working with startups. It’s a great explanation to customers on why they should do it and what some of the challenges are. The challenge that early stage firms encounter is that customers don’t usually understand they need to deal differently with a startup than an established technology vendor. Let’s be clear what “early stage” means. A company with 50 employees, a few million in revenue and a version three product is not early stage.

NIST Releases Recommendations for Securing Web Services

Fri, 08 Sep 2006 12:52:50 +0000

NIST Special Publication 800-95 addresses security needs for networks in which automated Web services are being deployed in service-oriented architectures. It’s only in draft but it covers the basics fairly well. If you’re doing business with the government and you plan to offer consumable services it’s worth making sure you follow the recommendations since the NIST requirements will start showing up in RFPs soon.

How to reduce database management costs

Fri, 08 Sep 2006 12:08:02 +0000

Our health IT databases, like in most other industries, are growing fast and sometime out of control. Every time we turn around there’s another database vendor, small access database, a big Excel file, or embedded database to contend with. Here are some quick but not easy ways to analyze and reduce your database costs: Virtualization — instead of putting everything on physical servers, use tools like VMware and Microsoft Virtual Server to store multiple vendor database servers onto a single physical server.

RFID is good for many things but increasing security is not one of them

Sun, 27 Aug 2006 15:05:55 +0000

As I travel around the country and speak to CTOs and CIOs about their hospitals infrastructure, implementing radio frequency identification (RFID) technology is one of the major items in everyone’s plans. While I’m always happy that RFID is taking hold in the minds of my clients, what worries me is that RFID is not mature enough yet to protect healthcare IT data but most vendors are not telling their customers during demos and pitches.

Web-based QA

Sat, 26 Aug 2006 13:28:40 +0000

I saw an interesting service offering recently. Check Autoriginate: Intelligent testing made convenient. Here’s how they describe themselves: HostedQA is the industry’s first web-based QA solution. With a focus on making automated testing convenient and ensuring that the resulting test scripts are intelligent, HostedQA is generations ahead of the competition. No longer do you have to settle for automating only the playback of your tests. HostedQA automates the entire automated testing cycle.

$10 Million available to Patient Monitoring Engineering Team

Thu, 24 Aug 2006 02:17:24 +0000

Business 2.0’s The $100 million giveaway article has an offer of $10 million for “an engineering team to design implantable wireless devices capable of 24/7 patient and data monitoring for conditions such as heart disease and diabetes.” It seems there’s decent startup money available if you’ve got the right ideas and can execute. Here’s the snippet from the article in case you’re interested: Patient Monitoring to Go The Investor: Corey Mulloy, general partner, Highland Capital Partners

Beware of vendors bearing SOA gifts

Thu, 24 Aug 2006 01:38:43 +0000

The healthcare sector manages an estimated 90 billing healthcare transactions globally; unfortunately, more than 90 percent are happening via phone, fax, or postal mail. In order for healthcare organizations to better manage today’s information technology requirements, they require modern tools that are designed to work with legacy infrastructures in a service oriented approach/architecture (SOA) where middleware is able to get information to and from multiple systems and applications that have likely been around for decades.

Please use the new rating system on my blog to tell me how you like articles

Thu, 24 Aug 2006 00:37:50 +0000

I just installed a new rating system that uses some cool AJAX functionality to allow you simply click on a star and rate the quality of the postings you read here. 1 star means the article is very weak and 5 stars means I’ve done great and that you found the article useful. My objective on this blog is to give unique, actionable advice and pointers to tips and views you won’t always get on other news sites so please take a moment when you read the articles to let me know what you think of each one.

Interesting Hopkins Study on Tracking Medication Error Reports

Wed, 23 Aug 2006 16:59:05 +0000

I ran across an interesting press release from earlier this year reporting that “Physicians, nurses, pharmacists equally prone to fault” for medication errors. The general findings in the article are pretty obvious but they have broken out the information in some useful ways. Here are some highlights from the article: “One of the more interesting findings was that drug-administering errors, such as giving the patient the wrong drug or the wrong dose or at the wrong time, were quite common,” Lehmann says.

Collaboration tools can transform healthcare IT but be careful

Wed, 16 Aug 2006 23:02:15 +0000

Web conferencing, instant messaging, blogs and wikis, messaging platforms, team collaboration, collaborative document management, email to fax, and barcoded documents can transform your health IT strategy. Unlike most knowledge management and other collaborative tools of yesteryear, most of the current tools are either free or very cheap. And, they don’t require much technical know-how to comprehend or install (because they don’t require any installation onto desktops in many cases). End users are already experimenting with collaboration tools and if IT departments don’t get a hold of what’s going on, they will lose control.

Healthcare app and devices design

Wed, 16 Aug 2006 03:40:25 +0000

I’ve been meaning to write an article on design of healthcare applications and devices for some time. Instead, I decided to go to an expert and get this thoughts. John Trenouth has a masters in design from Carnegie Mellon University and over a decade of experience designing interactive products and systems in both telecommunications and healthcare. Currently he blogs at niblettes and runs a boutique design firm Spire Innovation specializing in product innovation and design research.

Event: Profiling the Agile Architect

Wed, 16 Aug 2006 01:29:36 +0000

As many of you know, last year I co-founded the International Association of Software Architects’ Mid-Atlantic Chapter and we’ve had some great events in the DC area. This Thursday we’ve got Jeff Nielsen, Chief Scientist at Digital Focus, talking to us about Agile Architecture. Jeff trains and mentors teams and individuals in the use of agile methodologies and has over 19 years of commercial software development experience; he has architected a number of mission-critical and enterprise-level systems.

It’s harder to get out than get in

Mon, 14 Aug 2006 12:29:54 +0000

We’ve all seen it: we spend weeks or months in the “sales and demo cycle” for our applications. If we’re lucky we consider all workflows, if we’re even luckier we test drive the UI and make sure training goes smoothly, if we’re smart we also try to ensure that deployment will be easy. However, what we all seem to forget is to figure out how to get out of an application or system after it’s been installed for a while.

Guest article: Information Therapy

Tue, 08 Aug 2006 17:05:16 +0000

Dr Aniruddha Malpani, MD, an IVF specialist (Malpani Infertility Clinic), is an ardent patient advocate. He is the founder of what he has dubbed the world’s largest free patient education library, HELP (Health Education Library for People) in Bombay, India; and has authored the book, How to Get the Best Medical Care. I invited him to write a guest article here to talk about Information Therapy; he believes healthcare is too important to be left completely up to the doctor and I found his ideas intriguing.

Where can we get gigs of easily accessible storage for RIS and healthcare images?

Tue, 08 Aug 2006 01:45:46 +0000

If you’re looking for Inter-Enterprise storage of large files such as RIS images (where images need to be securely shared between organizations), check out Amazon Simple Storage Service (Amazon S3). This inexpensive service may have the right mix of price, performance, and scalability take care of your requirements. Here’s what Amazon says about it: Write, read, and delete objects containing from 1 byte to 5 gigabytes of data each. The number of objects you can store is unlimited.

Try Amazon Simple Queue Service (Amazon SQS) for cross-org messaging, RHIO, NHIN data

Mon, 07 Aug 2006 12:30:13 +0000

One of the foremost requirements of an Inter-Enterprise data interoperability (sending data between organizations) solution like a RHIO or even NHIN is to have a solid messaging service or technology. Buying a messaging engine for inside the interprise is fairly easy but setting one up for cross-organizational use is not trivial. One of the services that Amazon offers, called the Simple Queue Service (Amazon SQS), is a great option for multiple organizations that want to share data but don’t know how to do reliable messaging.

Let’s take off our ties and attend “Games for Health”

Sat, 05 Aug 2006 18:26:14 +0000

What can the healthcare industry learn from the gaming industry? Plenty. Tiny, superfast computers with 3-D technology, highly usable interfaces, and the fact that almost anyone can play even complex games can teach us a thing or two. The Games for Health 2006 Conference, being held near me in Baltimore, is the third annual installment of the gathering that is is designed to strengthen the intersection between health care and gaming.

Open source complex healthcare event/stream processing

Fri, 04 Aug 2006 01:39:22 +0000

If you need to process business rules or triggers based on large amounts of data that stream in from one or more sources, you probably need a tool like Esper. I’ve followed their development for a while and friend of mine just reminded me about its use in healthcare. Here’s what Esper does (from their website): Complex Event Processing, or CEP, is technology to process events and discover complex patterns among multiple streams of event data.

Another healthcare-specific search engine

Thu, 03 Aug 2006 16:15:49 +0000

Tom Eng, founder of a the health search engine company Healia, recently informed me that his new service has launched as a beta site. Tom said Healia is different from other search engines because: 1) it only provides high quality results, 2) it lets you filter your results to fit your profile and needs, and 3) it shows relationships among medical terms to help you search more accurately. Of course, the definition of “high quality” and results “fitting your profile” are subjective but it looks like a good start.

SmartDraw, another tool for healthcare diagrams

Thu, 03 Aug 2006 11:57:08 +0000

Last year I wrote about ConceptDraw, a diagramming tool for creating healthcare graphics. I just ran across another tool, The SmartDraw Healthcare Solution. It could certainly use a more catchy name but it seems pretty nice. It provides over 50,000 ready-to-use graphics, including over 3000 medical illustrations from Lippincott and 50 Netter images (which seems unique to them since ConceptDraw I don’t think has those). It’s only a few months old but it’s worth checking out if you’re getting tired of Visio because you have to hunt for your own healthcare-specific images.

I’ll be speaking at the Healthcare Blogging Summit 2006 in DC

Tue, 01 Aug 2006 00:31:53 +0000

Dmitriy over at The Medical Blog Netwok, an excellent blogging netwok for healthcare professionals who want to reach consumers, has been hard at work setting up the Healthcare Blogging Summit 2006. He asked me to join a panel on Strategy & Tactics and I said “of course” mainly because I believe in what he’s doing but of course also because it’s in my backyard. I think it’s going to be a great event and I look forward to seeing you guys there.

Taking The Pulse Of The Healthcare Blogosphere

Mon, 31 Jul 2006 13:25:17 +0000

For the past few months I’ve been doing consulting to help healthcare and other firms get started with “Corporate Blogging” and it’s been a great ride. One of the missing pieces has been statistical and detailed polling on the healthcare blogosphere so Fard over at Envision Solutions is running a survey to help fill the gap. If you’re a blogger in the healthcare space, please take a few minutes to participate.

Patient-centric devices in hospital rooms

Mon, 31 Jul 2006 12:07:29 +0000

This morning I interviewed Michael O’Neil, the CEO of GetWellNetworks, and he’s got a pretty interesting story to tell. A few years ago Michael was recovering from surgery to remove a malignant stomach tumor and spent many days in a hospital bed unable to do much other than stare at a TV up at the wall. He wanted more information about his condition and to communicate with his friends and family but felt helpless as he could do nothing more than wait for visitors and hope that he was getting better.

Electronic Medical Record Use by Office-based Physicians

Fri, 28 Jul 2006 13:38:49 +0000

The guys over at the BSTI Healthcare IT blog pointed me to an interesting CDC report on physicians’ use of EMRs. A couple of charts show the story:

Mirth Java-based open source HL7 Framework

Fri, 28 Jul 2006 03:33:41 +0000

David Kelton pointed me to this new open source HL7 processing framework called Mirth. I haven’t tried it out yet but it’s pedigree, design, platform, and architecture looks really good at first glance. Here’s how they describe the tool: Mirth is an open source cross-platform HL7 interface engine that enables bi-directional sending of HL7 messages between systems and applications over multiple transports. By utilizing an enterprise service bus framework and a channel-based architecture, Mirth allows messages to be filtered, transformed, and routed based on user-defined rules.

Healthcare IT Startup Advice

Thu, 27 Jul 2006 12:43:25 +0000

Over the past few months I’ve been approached by many startups to comment on their ideas and products. I love doing product reviews, especially for startups, because I’ve been an entrepreneur for years and I can’t help but offer advice (even when I’m not asked). Some of the common themes I’ve shared are listed here. Many of you are potential buyers of health IT startup products — what would you tell them?

Axure Prototyping Software

Wed, 26 Jul 2006 03:14:30 +0000

Check out the latest Axure RP prototyping software. Here’s what they claim you can do with it (from their website): Rapidly create wireframes in a drag and drop environment with easy to use, time-saving features. Generate HTML prototypes that clearly demonstrate the design and function in popular browsers. Generate specifications documenting the design in a professional, easy to read Word format.

CCHIT Town Call

Mon, 24 Jul 2006 17:40:31 +0000

I attended the Certifcation Commission for Healthcare Information Technology (CCHIT) Town Call for IT folks today and it was pretty useful. I’m still not convinced that CCHIT Certification will be truly useful for end users for some years, but I do think it is a good start to do something others aren’t doing yet to establish a “minimum standard” that vendors need to meet. Just as an FDA certification of a medical device doesn’t always mean that a device is suitable for all purposes, a CCHIT certification won’t always say whether something is the right product for a particular purpose, just that it meets minimum requirements.

HIT Vendors should create virtual appliances for their software

Sun, 23 Jul 2006 19:00:40 +0000

A virtual machine with pre-installed healthcare IT software/systems is something I’ve been looking forward to for a while. Closed source as well as open-source software based on technology from VMWare, Inc. would allow saving hours or even days of effort often required in installing healthcare IT software. Healthcare IT vendors should use VMware’s new virtual appliance software to create free downloadable zip files that contains a virtual machine (VM) with pre-installed software like MedSphere, VISTA, and similar software.

Dabble DB for quick but not dirty healthcare apps and databases

Sat, 22 Jul 2006 00:36:18 +0000

I recently came across the Dabble DB Web 2.0 service and feel it’s a great replacement for all those MS Excel, MS Access, and FileMaker databases we have sitting around our hospitals and offices. They say: Dabble DB combines the best of group spreadsheets, custom databases, and intranet web applications into a new way to manage and share your information on the web. But, that description doesn’t really do it justice.

HITSphere now tracking over 30 Health IT blogs

Tue, 18 Jul 2006 22:30:52 +0000

I started the HITSphere health IT blog aggregation engine and community with about 8 feeds just six months ago. It all started as my personal “dynamic blogroll” because I wanted to have a single page where I could scan what was going on in the health IT blogosphere. Throughout the past couple of months many more blogs have been nominated and accepted for display on the main page and even more inside the Community pages.

Short Course on Human Factors Engineering and Patient Safety

Tue, 18 Jul 2006 03:23:52 +0000

I just received an invitiation to the 2006 Systems Engineering Initiative in Patient Safety (SEIPS) Short Course on Human Factors Engineering (HFE) and Patient Safety. They could use a shorter name but it seems the course should be pretty interesting and I may try and attend if time permits. Here are the topics that will be covered: Human Factors Engineering Sociotechnical Systems and Macgroergonomics Design of the Physical Environment and Ergonomics Cognitive Ergonomics Usability of Technology Impact of HIT on Patient Care Process They describe the course as:

Using the Federal Transition Framework (FTF) to design your own governance documents

Mon, 17 Jul 2006 01:26:30 +0000

In case you haven’t seen it already, the OMB’s new Federal Transition Framework (FTF) is an excellent approach to creating architecture governance documentation. I’ve been working with federal agencies on various enterprrise architecture (EA) initiatives for several years now and one of the problems we’ve always had has been communicating what the initiatives are, why they are important, how strategic or tactical they are, how they should be scheduled, etc.

HIMMS interested in bloggers, blogging, and social networking

Sat, 15 Jul 2006 04:01:28 +0000

Today I spent some time being interviewed by a HIMMS marketing and communications group member and I was pleased by what I heard. The fellow on the phone seem genuinely interested in how we, as bloggers, see HIMMS as an organization and especially how they could better cater the 2007 conference to our small (but in his words “influential”) blogging community. He said HIMMS had been following blogs like mine and are very interested learning if the HIMMS 2007 Conference should have a blog and what it should look like.

Panel Recommends Initial Standards to Support Nationwide Health Information Network

Fri, 30 Jun 2006 21:38:28 +0000

Sounds like progress has been made on at least one of the myriad number of standards catalog efforts out there: an ANSI Panel Recommends Initial Standards to Support Nationwide Health Information Network. Here’s what the announcement said: Initial work has focused on the areas of biosurveillance, consumer empowerment, and electronic healthcare records – the three initial use cases identified by the American Health Information Community (AHIC). The ninety standards delivered today were identified by the Panel as being relevant and suitable for further consideration.

stpBA Storyboarding

Fri, 30 Jun 2006 19:50:17 +0000

A reader recently introduced me to this stpBA Storyboarding tool and I must say I’m impressed by the simplicity, low learning curve, and automated generation of important artifacts like requirements documentation, traceability, test scripts, and GUI screen flows. Using the stpBA tool mere mortals and teams without dozens of business analysts can actually do the right thing and improve their specifications phases without creating days worth of useless documentation activity. It’s definitely worth checking out.

My Clinical IT Outsourcing India trip: Days 3 & 4

Thu, 15 Jun 2006 15:40:40 +0000

I took down lots of notes about my next two days in India but didn’t have a chance to blog due to time and some connectivity issues. So, it’s a week late but I’m sure it’ll be worth reading. Days 3 and 4 were spent doing “deep dives” into architecture, design approaches, and potential implementation approaches. Having worked with offshore firms for many years, it’s clear that they think a bit differently but how does that translate into practical and deliverable work?

My Clinical IT Outsourcing India trip: Day 2

Wed, 07 Jun 2006 07:59:48 +0000

My second day in India (the first full day that I wasn’t half asleep) went well. I had to drive from my hotel in Old Bombay to the outsourcer’s office to New Bombay, which couldn’t have been more than 15-20 miles away but took 90 minutes to get there due to traffic. And the driver said that the traffic was good. And, the monsoon season hasn’t kicked in yet. Yikes!

My Clinical IT Outsourcing India trip: Day 1

Tue, 06 Jun 2006 03:27:32 +0000

As some of you already know, I’m in Mumbai and Bangalore, India this week working with a couple of outsourcing firms on clinical IT projects. I’ve been working with outsourcers in places like Pakistan, Russia, and India for almost a decade and it’s going to be great to get out to India to see how “offshoring” works first-hand instead of across thousands of miles. I can’t say I enjoyed my visit to my travel nurse before the trip.

Science in the year 2020

Sun, 21 May 2006 17:23:02 +0000

I ran across this interesting link at Microsoft Research: 2020 Science. From the website: In the summer of 2005, an international expert group was brought together for a workshop to define and produce a new vision and roadmap of the evolution, challenges and potential of computer science and computing in scientific research in the next fifteen years. The resulting document, Towards 2020 Science, sets out the challenges and opportunities arising from the increasing synthesis of computing and the sciences.

Guest Article: The Healthcare IT Gap

Wed, 10 May 2006 13:28:08 +0000

I was recently introduced to Dr. Stephen Beller and Mr. Sabatini Monatesi’s work at the WellnessWiki. I really liked what they were doing there so I asked them to write up an article on “The Healthcare IT Gap” to help us get their perspective on why existing HIT systems may not be enough to automate and improve healthcare. Steve is a licensed clinical psychologist with heavy expertise in software and has been working in the health informatics field since 1981.

Technology Support for Evidence-based Medicine

Wed, 03 May 2006 00:42:48 +0000

I recently attended our local Health TechNet meeting, run by David Main in Virginia, where Dr. Joseph Bormel of QuadraMed presented his thoughts on Evidence-based Medicine. I found the talk englighting but the conversation in the meeting (where there were nurses, physicians, and other practitioners present) even more enlightening. My pet peeve about evidence-based medicine is that most of us concentrate on the reasons why it’s hard and how we can’t get consensus on many important decisions (which is true).

Games for Health Day on May 9, 2006 in Los Angeles, California

Sun, 23 Apr 2006 16:49:50 +0000

The organizers of Games For Health asked me to announce their Games for Health Day event. I didn’t know much about it before but I find the ideas fascinating. Here’s how they describe the event: This one-day event, just before the opening of the Electronic Entertainment Expo will bring together researchers, game developers, and health & healthcare professionals for a series of talks devoted to how games and game technologies are addressing critical health & healthcare issues.

Biomedical Ontology in Action

Sun, 23 Apr 2006 16:15:52 +0000

A call for papers went out for an interesting workshop being held in Baltimore later this year. The Biomedical Ontology in Action event, organized by the National Center for Ontology Research (NCOR) and the Working Group on Formal (Bio-)Medical Knowledge Representation of the American Medical Informatics Association (AMIA), seems like a great gathering of ontology experts. Here’s how they describe their goal: This workshop aims at bringing together researchers from a broad range of fields that are related to formal ontology and medical informatics.

New York’s MIT Enterprise Forum hosting “Connected Healthcare” on May 4th

Sun, 23 Apr 2006 16:03:02 +0000

The MIT Enterprise Forum, a great organization that knows how to put together very useful events related to new business opportunities, recently announced the Connected Healthcare gathering to discuss medical technology and communications. Here’s how they describe the event: The newly coined phrase “Connected Healthcare” — and the related concept “Healthcare Unbound” — refers to communication and medical technology in, on and around the body that enables healthcare professionals to monitor and care for patients outside of the clinical setting.

Cooperative Open-source Medical Banking Architecture & Technology Reference Architecture

Thu, 20 Apr 2006 02:36:44 +0000

One of my readers, Ed Dodds, introduced me to the Cooperative Open-source Medical Banking Architecture & Technology reference architecture initiative known as C.O.M.B.A.T. It seems they are currently cooperating with the OMG (HL7-OMG Healthcare Services Specification Project workgroup) and various open source health initiatives (Eclipse Open Healthcare Framework, OpenEHR). He said that they anticipate a medical banking grid which would connect Healthcare Savings Accounts, portalized Electronic Medical Records, real-time remittance, and integrated charity care eligibility where medical data is expressed via cell phones, web tablets, and IPTV set top boxes (interactive home healthcare servers) as well as integrated remote disease management.

The downside of health IT: seeing fewer patients

Fri, 14 Apr 2006 14:13:07 +0000

Military.com posted an interesting article last week on how the Defense Department’s electronic medical record-keeping system,AHLTA, has reduced patient access to many military outpatient clinics and has lengthened workdays for many doctors. A few notable quotes from the article: “It takes on average two to four times more time to document in AHLTA than it did when we used paper,” Nelson said. “For a simple visit like pink eye, patient time can take as little as three to four minutes to diagnose and explain to parents.

Health IT systems and medical devices should learn about CAP

Tue, 11 Apr 2006 13:26:46 +0000

The Common Alerting Protocol (CAP) and Emergency Data Exchange Language (EDXL) are two standards that have been promoted by organizations that need to transfer information to each other during times of emergencies (natural disasters, terrorist incidents, etc). There are lots of vendors supporting CAP but I haven’t seen much use within health IT or medical devices so I thought I’d blog about what CAP and EDXL are so that our CIO and CTO readers out there can help their own teams understand why it might be important to learn about the standards.

Ken Kizer, CEO of Medsphere and former top VA official, pitches open source medical software to Congress

Tue, 11 Apr 2006 02:48:13 +0000

Kenneth Kizer spoke to the Ways & Means Committee in the U.S. House of Representatives last week. He pitched the virtues of electronic medical records but focused on open source. He suggested that Congress make the selection of open source software the default mode for federal funds. Here’s what he said specifically: Open source software is less well developed in health care than for some other enterprises, but open source software solutions for health care are now rapidly evolving.

Healthcare Blogs: The Authoritative Guide

Sun, 09 Apr 2006 17:34:08 +0000

Over the past several months, I’ve had the pleasure of participating in a special project that Fard Johnmar of Envision Solutions has been involved in. He first contacted me in early January about an interview I participated in with John Cass of Backbone Media. In that interview I spoke about the fear pharmaceutical companies have of the blogosphere and why they should be embracing this medium rather than avoiding it. Fard told me that he was working on a report on healthcare blogging and I agreed to be interviewed for it.

The Connecting for Health Common Framework

Fri, 07 Apr 2006 22:58:09 +0000

The Markle Foundation recently unveiled their Common Framework on the Connecting For Health website. Here’s how they describe the project: The Common Framework provides an essential set of technical and policy resources for private and secure health information sharing among existing and developing health information networks. All of the Connecting for Health Common Framework resources are available here at no cost. The Common Framework includes 16 technical and policy components developed by experts in information technology, health privacy law, and policy, and tested since mid-2005 by Connecting for Health prototype teams in Indianapolis, Boston, and Mendocino County, California.

Guest Article: Beware of NULLs in healthcare databases

Wed, 05 Apr 2006 12:51:30 +0000

Many readers have been asking for more “practical” advice on their database models so I’ve asked a fellow healthcare data architect to lend a hand. Tom Maloney is a Senior Data Architect for Stockamp and Associates with over 25 years of experience and knowledge working with and designing databases for most industries. Tom has done a lot of freelance contracting through his own company where he lives and breathes data modeling.

XML data models are viable alternatives to relational data models in healthcare systems

Fri, 31 Mar 2006 12:14:45 +0000

I have received many comments on my recent Data Models in Healthcare series of articles and all of them have been pretty good. One of the more detailed and thoughtful responses came from Daniel Essin, a physician who is the Director of Medical Informatics at Los Angeles County Hospital and CTO of ChartWare. He wrote about using XML data models for clinical data management and in general I agree that XML is a viable persistence model for the use case he refers to.

Healthcare Services Specification Project

Sun, 26 Mar 2006 21:30:48 +0000

A reader (thanks Ed) just sent me this link to the Healthcare Services Specification Project that I thought might interest many of you. They describe their project as: This project is a collaborative effort between Health Level Seven and the Object Management Group to identify and document service specifications, functionality, and conformance supportive and relevant to healthcare IT stakeholders and resulting in real-world implementations. In addition, several other groups have joined the HSSP effort.

Introduction to Dynamic Data Models in Healthcare

Fri, 24 Mar 2006 14:32:56 +0000

Health-IT World.com recently published my Introduction to Dynamic Data Models in Healthcare article. It’s a follow-on to my Healthcare Data Models Matter column from a couple of weeks ago.

Very nice auto-recognition and auto-login system for healthcare workstations

Sun, 19 Mar 2006 16:29:09 +0000

I met the founders of SensibleVision, creators of the Fast Access computer security and access control software, at HIMSS a few weeks ago. I was fascinated because it’s one of those few security applications that you can understand in under a minute. Fast Access is a program that installs onto Windows workstations and allows users to simply sit in front of their computers and be automatically logged in using facial recognition.

Interested in doing some freelance writing for a Health IT publication?

Thu, 16 Mar 2006 13:19:07 +0000

An editor from a large health IT publication with both a print and online presence has asked me if I know any folks looking to do any freelance writing on “practical” health IT topics. If you’re interested, drop me a note.

Conference on Intellectual Property in the Global Marketplace

Thu, 16 Mar 2006 13:00:51 +0000

I’m a patent holder and I train patent examiners on technology topics so I often see and sometimes work with the folks at the U.S. Patent and Trademark Office (USPTO). If all you know about the USPTO is what you read in the newspapers you should attend some events where you’ll meet the folks that work there. If have found most of the staff that I’ve encountered to be courteous, hard-working, caring, and really trying to do the right thing as often as possible.

Medical Blog Network vs. Lynch Mob

Tue, 14 Mar 2006 13:38:19 +0000

Dmitriy over at HealthVoices just posted about the medical blog aggregating “debate”. In case you’re not aware, HealthVoices is both a medical blog content aggregator and a blogging community where medical bloggers can get national recoginition for their writing. I met Dmitriy at HIMSS and I was impressed by his knowledge, dedication to the medical community, and his innovative ideas about how something like HealthVoices could help physicians and other healthcare providers get messages out to patients and citizens.

EHRs in the Exam Room: Tips on Patient-Centered Care

Tue, 14 Mar 2006 00:25:53 +0000

The AAFP has a shiny new white paper with tips on how to use EHRs in the exam room. They say “with a thoughtful approach, you can maintain your focus on the patient.” In their introduction they point out that most people talk about how to buy and deploy EHRs but that “minimal attention has been paid to understanding how family physicians use EHRs with patients in the examination room.”

Whitepaper on Open Source in Healthcare

Fri, 10 Mar 2006 17:22:54 +0000

My friend Adam Weinstein, a senior engineer at CardinalHealth, pointed me to the iHealthReports Open Source Primer for Healthcare whitepaper. Since it’s a primer it’s not too enlighting for many of us who’ve been in open source for a while but it’s quite good as an introduction to folks in healthcare who may have just started hearing about open source and wondering why it might be relevant to them. Some useful arguments come from their Executive Summary:

Wikipedia vs. Encyclopedia Britannica: The Kid’s All Right (And So’s the Old Man)

Fri, 10 Mar 2006 17:11:23 +0000

With all the great “community-focused” work going on in the healthcare world, we can see growth in community-powered clinical information. Projects like ClinWiki are letting contributors build unmoderated (or less-moderated) clinical knowledge bases. I read this nice article this month about Wikipedia and how it compares with Encylopedia Briannica. It’s a good article that demonstrates the strenghts and weaknesses of top-down versus bottom-up information publishing approaches.

Should we develop a healthcare domain-specific language (DSL)?

Fri, 10 Mar 2006 13:21:57 +0000

Artima Developer recently started a discussion on How and When to Develop Domain-Specific Languages. It was a good discussion and made me think about a couple of DSLs I’d written for healthcare during my dot-com CTO days. I was wondering if others had done the same and whether they’d like to share their DSLs with the rest of the healthcare IT community.

Handheld Computers in Medicine workshop on 6th April in London

Fri, 10 Mar 2006 12:48:52 +0000

The Royal Society of Medicine is running the third annual Handheld Computers in Medicine workshop on 6th April in London. The workshop is a day long event split into two streams, one for beginners chaired by Dr Chris Paton (New Media Medicine) and one for more advanced users chaired by Dr Mo Al-Ubaydli (Mo.md). Handheld computers will be provided for the day for participants to follow along with the demonstrations and try out medical software applications.

Health Wonk Review up over at THCB

Thu, 09 Mar 2006 23:04:30 +0000

Health Wonk Review, the almost-new round up of the good and the great in blogging about health care policy, business and technology, is up over at Matthew’s The Health Care Blog.

Electronic Health Rrecords Vendors Association (EHRVA) Interoperability Roadmap V2.0

Thu, 09 Mar 2006 22:25:22 +0000

The EHRVA Interoperability Roadmap is available. Here’s how they describe it: The EHRVA Interoperability Roadmap supports the national goal of interoperable electronic health records and provides a pragmatic, logical plan that will succeed when adopted and implemented by key stakeholders. We provide this Roadmap to mobilize the leadership of healthcare organizations, information technology vendors and other relevant stakeholders to collectively deliver on the vision by incorporating this Roadmap into their plans.

79% of U.S. Internet uses have researched health information online

Tue, 07 Mar 2006 23:28:19 +0000

So, what’s the big deal? Well, according to the Pew Internet & American Life Project only 73% of us get news online. So, Pew seems to log more people as having researched health information online than receiving news. This is a great trend for those of us in health IT who want to create Software as a Service (Saas) offerings that present useful health information and health IT solutions via the Internet.

Check out GotoMeeting and GoToMyPC for remote access to medical and clinical workstations

Mon, 06 Mar 2006 13:57:08 +0000

I’ve been using Citrix software for years and more recently I’ve started using GotoMeeting.com for getting together with my clients and employees remotely. GotoMeeting allows unlimited online meetings for up to 10 people at a time for a small monthly fee. It allows me to hook up with my clients and their PCs anytime I want — the clients love the immediate service and we can get multiple parties together at a moment’s notice without installing new software on multiple PCs.

A reader’s elaboration of my “better engineers” argument

Mon, 06 Mar 2006 13:54:31 +0000

Dale Hunscher commented on my earlier posting about best language selection for HIPAA security. He made my point better than I did so I thought I’d raise the comment to a level where everyone can see it. I agree with the post about the need for “good developers”, but I think that needs clarification, by way of expanding on Administrator’s comment above. Many programmers/software engineers have no real understanding of what kinds of programming practices create security holes.

JScience Java library for scientific computations

Fri, 03 Mar 2006 15:42:50 +0000

Java programmers who happen to do “real world” scientific work should check out JScience. Their vision, according to the website is: To provide the most comprehensive JavaTM library for the scientific community. To create synergy between all sciences (e.g. math, physics, sociology, biology, astronomy, economics, etc.) by integrating them into a single architecture. To provide the best on-line services (webstart) for scientific calculations and visualizations.

Start using RSS for health/medical alerts and data sharing

Fri, 03 Mar 2006 14:44:23 +0000

As most of us bloggers already know, Really Simple Syndication (RSS), is pretty popular in the blogosphere. It’s a wonderful solution to the “how do I tell everyone I have new stuff without sending out a bunch of emails?” problem. Although it’s quite popular for syndicating content like news, blog articles, and related information I think RSS has a chance to make a huge impact on healthcare and medical data sharing.

Software vendors should start providing virtual machine images to help demo their wares

Thu, 02 Mar 2006 16:15:26 +0000

Open source software is often difficult to install and get up running so “trying it out” is not trivial. We need web servers, application servers, database servers, etc all working in tandem just to check out some software. On the commercial side things are a little better but still complicated. My good friend Faisal Qureshi, who’s in the healthcare IT professional services and consultancy business, left a comment on one of my recent open source articles about how difficult it is to install the open source solutions and suggested that using virtual machine software like VMWare, which is now free for many licensing options, would make it significantly easier for customers to try out software.

HIPAA certification business for software vendors a good idea?

Wed, 01 Mar 2006 15:43:45 +0000

A reader recently asked: Is there a group that ‘hipaa certifies’ online healthcare vendors/providers as Verisign does for security? It would be a neat business idea because I keep reading stats about 50% or lower compliance levels. While I do lots of HIPAA work, I thought I’d invite a buddy of mine who knows even more about the subject to respond to the question. Bob Burns, who’s been working on healthcare IT systems for almost as long as I’ve been alive [he’s gonna kill me for saying that ;-)], wrote back:

Health Wonk Review: A healthcare policy, technology, and business blogs carnival

Sun, 26 Feb 2006 16:07:03 +0000

Joe Paduda, Matthew Holt, and others have started the Healthcare Policy, Business, Technology & “Non-clinical” Issues Carnival called Health Wonk Review. Here’s how Matthew described the new Carnival: Inspired by the Nick doing Grand Rounds, Joe Paduda at Managed Care Matters has put together the first bi-weekly edition of a compendium of the best of blogging about health care policy, business, technology and anything that isn’t really clinical in nature.

Securing Your Desktops from Pod Slurping

Sat, 25 Feb 2006 03:19:12 +0000

The EMR and HIPAA blog has posted additional information on “pod slurping”: Securing Your Desktops – Pod Slurping. He’s started a good discussion out there and we should join in to see if we can talk about policies health IT shops should put into place.

Why vendors don’t implement CCOW in legacy systems

Thu, 23 Feb 2006 14:07:38 +0000

Wheelybop, A HIStalk reader, recently posed a question: Can you or your blogger network describe to me what vendors have to do to make their legacy products CCOW compliant and why some refuse to do so, what are pros/cons, etc. Would love a CCOW primer or be pointed to such. First, lets tackle the primer. The acronym CCOW stands for “Clinical Context Object Workgroup”, a reference to the standards committee within the HL7 group that developed the standard.

Best language for secure healthcare applications

Thu, 23 Feb 2006 01:18:42 +0000

I got an email from a reader recently, asking: I have a quick question – I was wondering if there is a programming language that is viewed as ‘more secure’ for patient data compared with others? I am building a program to collect patient health info, and am in the very early stages of planning. I used Java previously that worked well for a very sophisticated algorithm to mine data, but this new application is very simple (basically a questionairre) and I have heard .

Beware the ‘pod slurping’ employee

Mon, 20 Feb 2006 15:54:40 +0000

I wrote about “pod slurping” a few weeks ago but cNet News.com did a better job. CIOs of hospitals and healthcare IT managers need to pay attention to what they said: A U.S. security expert who devised an application that can fill an iPod with business-critical data in a matter of minutes is urging companies to address the very real threat of data theft. Abe Usher, a 10-year veteran of the security industry, created an application that runs on an iPod and can search corporate networks for files likely to contain business-critical data.

HIMSS 2006: Harmonization and interoperability getting more than lip service

Fri, 17 Feb 2006 23:34:48 +0000

Walking around the exhibits with my customers and fellow bloggers at HIMSS this year I found that harmonization and iteroperability were two themes that most vendors were touting. Ubiquity of networks (through wireless technologies) will allow excellent location-based awareness and medical devices will be more and more connected. Given the connected nature of hundreds, perhaps thousands of network-centric devices in our hospitals, we’ll need to make sure that data can interoperate and that it’s harmonized (semantically as well as structurally).

J2EE Architecture of Brazilian Healthcare IT System

Fri, 17 Feb 2006 12:35:46 +0000

TheServerSide discusses The J2EE Architecture of Brazilian Healthcare: In Brazil, every citizen has the right to full healthcare, from primary care to complex procedures as heart transplants, for free, any place in the country. With a population of 180 million people, information is the key to better distribute resources and provide better healthcare. Taking advantage of the Java based infrastructure of the Brazilian National Health Card, in 2003 a huge project was started aiming to build an integrated web based application to collect patient encounter information, to regulate complex procedures authorizations and to build an integrated patient scheduling system that would allow to schedule consultations and medical procedures in any health provider.

First annual HIMMS Blogger/Reader meetup was a smashing success

Mon, 13 Feb 2006 16:47:55 +0000

I just wanted to thank all of you that attended the meetup last night in San Diego. We had dozens of people coming in and out and everyone I talked to said they had a great time. Special thanks go to Will Wieder (CandidCIO) for coming up with the idea and to Tim Gee (Mr. Connectologist) and Neil Versel for making the venue arrangements. We had bloggers and readers from the healthcare policy, provider, financial, IT, infrastructure, media, and vendor communities represented.

Grand Rounds is up

Tue, 07 Feb 2006 16:15:28 +0000

This week’s Grand Rounds is now available at Science & Politics.

caBIG Healthcare Enterprise Security Architecture White Paper

Tue, 07 Feb 2006 15:39:21 +0000

If you’re working on federated security for multiple health IT systems, take a look at the new NIH caBIG (Cancer Grid) Security Architecture White Paper. I was one of the reviewers on the paper and it is quite well done. It demonstrates the complexity of securing a computing grid, multiple services & systems, and various organizations. And, it provides an evaluation report on various techniques so that you don’t have to do the work all over again in your own project.

Pharma: Have No Fear Of The Blogosphere

Sun, 05 Feb 2006 20:04:29 +0000

Fard Johnmar, founder of Envision Solutions (a healthcare marketing communications consultancy) published my Pharma: Have No Fear Of The Blogosphere on his blog this morning. It’s another step in my continuing effort to get medical device manufacturers, big Pharma, and other “regulated products” providers to start corporate blogging. Lets see if it gets any discussions going.

Thoughts on the Future of Medical Devices at the Point of Care

Sun, 05 Feb 2006 17:27:59 +0000

Tim’s got an excellent article describing his Thoughts on the Future of Medical Devices at the Point of Care.

HIMSS exec denies conflict in role on RMD board

Sat, 04 Feb 2006 16:57:40 +0000

I’ve commented numerous times on my general fear of conflict of interest between doctors and pharma firms so it was great to be interviewed on a related subject by Modern Healthcare. Andis interviewed me for his piece HIMSS exec denies conflict in role on RMD board. I told Andis that Davis’ appointment to the board of advisors at a for-profit health IT firm while he’s currently serving as a HIMSS executive is nothing new or terribly worrisome so long as it’s public and transparent.

Medical data theft through Podslurping

Fri, 03 Feb 2006 15:24:06 +0000

Podslurping is getting to be a problem in corporate environments so it’s going to be a problem in hospitals and doctors offices, too. This is an “insider theft” issue when a large memory/disk device like an iPod is connected to a computer and it “slurps” data from behind a firewall into a portable system and data theft occurs. My fellow CXOs please be sure you have policies in place as to whether or not you allow USB devices to be installed at clinical or financial workstations.

Health IT vendors should learn from Oracle, Microsoft, IBM, and MySQL

Wed, 01 Feb 2006 22:03:54 +0000

As most of us who follow the database world know, MySQL is the “little database that could”. For years it has been running millions of transactions across hundreds of thousands of websites supporting millions of online customers. MySQL AB, a tiny Swedish company with only about $20 million in revenue last year, now has so many customers and users that the Big 3 players have had to respond by releasing free editions of their software just to make sure they are still relevant for new or small projects.

2006 Government Health IT Conference & Exhibition Call for Participation

Wed, 01 Feb 2006 05:44:08 +0000

The Call for Paticipation for the 2006 Government Health IT Conference & Exhibition has gone out. This year the conference is being held on June 15 and 16 at the Ronald Reagan Building in Washington, DC. Here’s how the organizers describe the event: The Conference will bring together government health care professionals to discuss their experiences and share strategies for success using information technology to improve quality, enhance patient safety, and increase efficiency in health care services.

De-identifiying protected health information (PHI)

Tue, 31 Jan 2006 19:54:01 +0000

A number of clients have been asking me about protected health information (PHI) solutions so I thought I’d put out a general call for help from my esteemed readers. What I’m looking for is a general-purpose data de-identification library (preferably open source) that I could use in both OSS and commercial systems. Even if it costs money, I’d love to hear about it. The idea is to be able to find PHI automatically in any arbitrary data packet (HL7, e-mail, database, etc), be able to flag it, do a one-way hash, tokenize it, add it to a dictionary, etc.

EJK’s no-contact thermometer

Tue, 31 Jan 2006 15:01:59 +0000

Engadget reported about EJK’s no-contact thermometer this morning. Pretty slick.

How to manage tape backups in health IT shops

Tue, 31 Jan 2006 02:08:12 +0000

These days we’re hearing more and more about how backup tapes, which are crucial for business continuity and disaster recovery purposes, are getting lost due to carelessness or transfer problems. Many of you are CXOs in charge of technology and information systems and I’m hoping you have had a chance to review your off site backup tape storage policies. Off site storage is crucial if you use backup tapes so that a fire or other disaster doesn’t take along your backups with your primary systems.

Math Will Rock Your World

Sun, 29 Jan 2006 18:04:01 +0000

BusinessWeek has a nice article in last week’s issue: Math Will Rock Your World. Most health IT applications, e-Health services, etc are usually nothing more than glorified data entry systems. Lets take some of the advice of the entrepreneurs cited in the article and move towards better analysis of the information we’ve been gathering in our systems for decades. Math and data mining could actually bring real value to our health IT apps.

Light HL7 Library for Java

Sat, 28 Jan 2006 23:41:02 +0000

Mike, who works at Cleveland Clinic, has released the Light HL7 Library for Java. Here’s how he describes it: The Light HL7 Library let’s you simply parse, modify and create HL7-like messages in Java. This is the same parsing library used by the HL7 Browser and HL7 Comm, and internally at CCF, so it has literally parsed millions and millions of records.

How we carry $10,000 cash versus patient data backup tapes worth much, much more

Sat, 28 Jan 2006 18:51:05 +0000

I just read another data theft article. The Seattle Times reported Patients’ information stolen in 3 thefts. This time backup tapes (which I warned about in an earlier post) were left in a personal vehicle which was broken into. I can’t tell you how many times I’ve walked around in a hospital or provider parking lot and seen medical record folders sitting in physicans’ cars. That’s bad, but thieves (if they broke in) could only get a few records at a time.

Health-IT vendors must consider Open Source

Wed, 25 Jan 2006 03:07:21 +0000

I got some good comments on my recent article where I suggested that QuadraMed open source their solution in order to help them gain more sales. There were a number of folks who asked for more information about why vendors should consider open sourcing their products so I put together this article, which was also published in today’s Health IT World newsletter. Update: the Health IT World website has now published the article, too.

HIMSS’06 Blogger and Reader Meetup Registration

Tue, 24 Jan 2006 03:52:33 +0000

After a couple of weeks of voting, the bloggers and readers have come up with a day, time, and location for the HIMSS’06 Blogger and Reader Meetup. By popular request the meetup will be on Sunday evening after the HIMSS reception at 8:30pm at Hennessey’s Gaslamp (map). If you think you’ll be attending, please be sure to register so we can plan accordingly. If you’d like to see who’s attending, take a look at those who have already registered.

Great use of health IT: inmates to visit doctors electronically

Thu, 19 Jan 2006 19:44:49 +0000

AP is reporting about how prison inmates will be visiting doctors electronically in Kentucky. More specifically: Inmates in Kentucky’s jails and prisons will receive most non-routine medical visits electronically under a new program designed to save time and money, Lt. Gov. Steve Pence said yesterday. The program, already in limited use, is expected to expand to all 13 prisons and 75 jails in the state by spring. What’s great here is that service will improve but costs may decrease by up to 40%.

Search Engines, Blogs Lead Top E-Health Trends for 2006

Wed, 18 Jan 2006 16:15:28 +0000

Health-IT World reports Search Engines, Blogs Lead Top E-Health Trends for 2006. People and organizations marketing e-health products and services would do well by paying close attention to search engines and formerly “alternative” media such as blogs and online video in 2006, a top healthcare information firm says. Consumers and physicians alike increasingly are turning to search engines to find health information on the Internet, rather than pointing their browsers toward specific, known Web sites.

Blogging Your Way Up the Career Ladder

Wed, 18 Jan 2006 15:26:31 +0000

Eric Spiegel writes in Datamation’s online magazine about Blogging Your Way Up the Career Ladder. The article discusses how professionals, especially in IT, can enhance their careers through blogging. The column features some of my ideas on the subject as the central interview subject.

HITSphere now tracking over 20 HIT blogs

Mon, 16 Jan 2006 17:19:46 +0000

It was only a couple of months ago that I started the HITSphere health IT blog aggregation engine and community with about 8 feeds. Throughout the past couple of months many more blogs have been nominated and accepted for display on the main page and even more inside the Community pages. Check out the HITSphere — it’s diverse and pretty encompassing now. If you know of more that should be added, please let me know.

If your engineers and DBAs can see medical data, it’s neither private nor secure

Sat, 14 Jan 2006 22:32:01 +0000

There is a general misconception in the health IT community that their database servers are somehow their most secure systems and that because they are secure their patients’ healthcare data and their own financial information is safe. As a health IT architect let me clue you in on this is a dirty little secret: many databases are neither secure nor safe from data tampering or theft. Although lots of data may be stolen by hackers for identity theft, a great deal of other data theft occurs from insiders who could benefit from sale of such data.

Polls closing in 2 days for 2005 Medical Weblog Awards

Fri, 13 Jan 2006 21:06:30 +0000

Friends, just a quick reminder that if you like what you read here, please take a moment and voice your opinion by voting at the 2005 Medical Weblog Awards. Since my blog has only been around for 3 months I’ve been surprised and humbled by my readers’ generosity in spending their precious time voting for me in the three categories I was nominated in: Best Medical Weblog Best New Medical Weblog Established in 2005

The Cost of Exhibiting at HIMSS

Fri, 13 Jan 2006 02:27:26 +0000

Tim over at HIStalk has a very revealing guest article today: The Cost of Exhibiting at HIMSS (HIStalk). Since I’ve been in the product space (both HIT and non-HIT) for a while and know about the costs of exhibiting at many of these conferences it wasn’t news to me about why little guys are underrepresented. HIMSS isn’t much better or worse than, say, JavaOne or other tech conferences but if you don’t know how much small companies spend on HIMSS it’s a good case study.

QuadraMed should go open source

Fri, 13 Jan 2006 00:44:46 +0000

QuadraMed, a company with little new sales in all of 2005, has great untapped potential. They’ve got a product that customers seem to like (good KLAS rating and happy customers) but they can’t seem to compete with the big boys (stability and size) or the little guys (price and agility). Their stock has been depressed and their market cap is less than $60 million as of today. Now, they’ve been busy with management and other structural changes but there’s no reason to believe that they’re on an immediate bounceback trajectory (it’s too early to tell what new changes will be made).

JAMIA reports it will be 2024 by the time EHR adoption will reach its full potential

Thu, 12 Jan 2006 01:30:29 +0000

Statistical modeling in the recent JAMIA article Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless? presents some interesting results. The study focused on small practices (where most of our EHR adoption trouble happens) and used EHR adoption data from six previous studies to estimate potential future market penetration rates. Based on their conservative models, they said: Under current conditions, EHR adoption will reach its maximum market share in 2024 in the small practice setting.

IEEE Endorses “Proper” Use of Technology in Improving Health Care for Seniors

Tue, 10 Jan 2006 13:38:00 +0000

Check out this article, where IEEE-USA talks about how technology can improve healthcare for United States’ growing aging population. Nothing profound, but I’m an IEEE chapter chair and long time member so I found it interesting that a press release like this was actually necessary. Are there still people that need to be convinced?

Healthcare career advice and job hunting tips

Mon, 09 Jan 2006 18:15:03 +0000

I just ran across healthcare.wurk.net, a blog for career advice and jobhunting in the healthcare industry. Like all good blogs, it’s focused and useful. It’s not specific to health IT, but it’s worth checking out.

Guest Article: Standardizing Computer Interfacing to Medical Devices

Mon, 09 Jan 2006 15:30:27 +0000

This is a guest article, written by Nicholas Cain, CEO of Cain Medical. Cain Medical is the developer of CMSense, a solution for integrating multiple medical devices into legacy or modern health IT applications. I invited Nicholas to share his thoughts about connecting to medical devices because there are more and more specialty medical devices entering our organizations and all those devices generate excellent clinical data that should be captured and managed by our existing applications.

Healthcare blogger and reader meet-up at HIMSS in San Diego

Sun, 08 Jan 2006 16:48:49 +0000

Are you looking for something new and exciting to do at HIMSS this year? Want to attend an event that’s modern, hip, and perhaps more informative than the usual vendor events? Well then, you’re in luck. Your friendly neighborhood bloggers are considering a meet-up at the HIMSS ’06 conference next month in San Diego. Will over at Candid CIO came up with the idea and it met with unanimous approval of it being a great idea through several e-mail exchanges with other bloggers this weekend.

Correctness by Construction: A Manifesto for High-Integrity Software

Fri, 06 Jan 2006 03:29:33 +0000

Clinical systems and medical devices, which deal with the lives of real people, fall into the category of high integrity systems which can’t tolerate any defects. Correctness by Construction: A Manifesto for High-Integrity Software is a great article talking about how to create low- or zero-defect software while still maintaining good developer productivity through an agile methodology. The article’s abstract says: High-integrity software systems are often so large that conventional development processes cannot get anywhere near achieving tolerable defect rates.

Semantic Interoperability of Medical Information Systems

Thu, 05 Jan 2006 14:48:35 +0000

A friend of mine sent me a link reporting about the Artemis Project, which is described as a A Semantic Web Service-based P2P Infrastructure for the Interoperability of Medical Information Systems. Quite a mouthful. There’s a good introductory PowerPoint presentation as well. They’ve done a good job taking all the stuff we’ve been working on in the semantic web workgroups and applied it directly to healthcare data interoperability through web services standards.

Guest Article: The benefits of interfacing computers to medical devices

Wed, 04 Jan 2006 17:07:41 +0000

20 Messaging and Vocabulary Standards for Government Health IT

Wed, 04 Jan 2006 05:25:27 +0000

Tim’s got a good story about the federal government’s choice of health IT messaging and vocabulary standards selection over at Medical Connectivity Consulting. Worth reading, especially since he did the legwork to find the correct link for the standards list. I know a couple of the guys who worked on creating this list (on the Feds side) and although the list looks like it was pretty easy to put together, I can assure you that it was not as simple as it looks.

New vending machine dispenses generic prescription drugs

Tue, 03 Jan 2006 19:40:23 +0000

Why didn’t we think of this before? AP reports about a new vending machine that dispenses generic prescription drugs. Now, if only this thing could send out HL7, SNMP, REST, or SOAP messages via TCP/IP we could capture the information directly into a medical record.

Nurses check on patients via Internet

Tue, 03 Jan 2006 19:25:54 +0000

This is my kind of medicine: Nurses check on patients via Internet. From the article: Operated through a phone line, “home telecare” devices are hooked up to stethoscopes and blood pressure and oxygen readers that transmit results to a remote station monitored by a nurse or doctor. The technology saves providers time and gets patients timely attention without ever having to leave their homes, advocates say. This kind of remote monitoring and care will only grow (and as soon as there are hard numbers to show cost reduction it will skyrocket).

Computers with patients’ information stolen from office

Tue, 03 Jan 2006 19:03:42 +0000

AP reported a couple of days ago about computers with patients’ information being stolen from a Pennsylvania medical office. Computers being stolen are nothing new. Data being taken is nothing new. But, the kind of data being stolen of course can make all the difference in the world. In this case (as in most cases) the theft probably occurred because it was easy to do and the computers have some resale (fence) value.

Polls Are Open for 2005 Medical Weblog Awards

Tue, 03 Jan 2006 16:05:08 +0000

If you like what you read here, please take a moment and voice your opinion by voting at the 2005 Medical Weblog Awards. I’m flattered just to be nominated, but getting some votes would make me feel even better :-). I’m nominated in the following categories: Best Medical Weblog Best New Medical Weblog Established in 2005 Best Informatics Weblog I thank everyone who nominated me for their kindness. Thanks in advance for those who cast their vote in my favor in one, two, or all three of the categories.

Oracle aims to lock in low-end users

Mon, 02 Jan 2006 23:15:38 +0000

BusinessWeek and VNUnet reported that Oracle is offering a free version of its database for low-end users. Some VNUNet excerpts: Oracle is developing a free version of its database designed to lock in low-end users. The company released a beta of Oracle Database 10g Express Edition on Monday as a free download which can be freely distributed as an embedded database. A final version is scheduled for availability later this year.

Another open source EMR list

Mon, 02 Jan 2006 22:46:11 +0000

Due to popular demand (I got a few more emails about my RedHat discussion from Saturday), here’s another list of existing open source Electronic Medical Records (EMR) solutions.

No RedHat equivalents in health IT…yet

Fri, 30 Dec 2005 02:53:28 +0000

This morning one of my readers (a doctor) posed a great question: Why is there no “Red Hat” equivalent in medicine? I come from a family with members in VC and keep getting pitches for proprietary software for everything from EHR/PHR to radiology PACS systems etc. Do you know of any providers of open source medical software? The simple is answer to his question is that there is no real RedHat equivalent in the medical software arena.

Windows Media Center for eHealth

Thu, 29 Dec 2005 05:01:16 +0000

Dr. Clifford Goldsmith, Director of the Provider Industry group in Microsoft’s Healthcare and Life Sciences unit, had some great ideas in his recent Windows Media Center (MCE) for eHealth article. As a regular user of MCE I totally agree with him that it’s a good platform for communicating with patients within the home. MCE is not that prevalent yet, but perhaps with the right “killer healthcare IT app” it could make some inroads for elderly or chronically ill patients.

Open-source and non-proprietary health IT software (podcast)

Thu, 29 Dec 2005 04:45:49 +0000

Neil’s been putting together some nice health IT blog articles for some time but I recently caught his excellent podcast interview with Fred Trotter of ClearHealth. The details are available here. It’s worth checking out.

How To Write Unmaintainable Code

Thu, 29 Dec 2005 03:18:17 +0000

Roedy Green published a great article on something most of us in health IT deal with regularly: code that’s difficult to manage and maintain. He says you can ensure a job for life if you learn How To Write Unmaintainable Code. From his introduction: In the interests of creating employment opportunities in the Java programming field, I am passing on these tips from the masters on how to write code that is so difficult to maintain, that the people who come after you will take years to make even the simplest changes.

Free/Libre Open Source Software (FLOSS) Healthcare Community

Tue, 27 Dec 2005 23:48:18 +0000

A new forum for discussion of healthcare software and issues is available at FLOSS Healthcare Community. It’s not a US-based site (European) but could still have plenty of applicability to our requirements here in the USA.

Federal Chief Architects Forum establishes Health Information Technology Ontology Project (HITOP) Work Group

Sun, 25 Dec 2005 14:28:01 +0000

From the HITOP mission statement introduction: The Health Information Technology Ontology Project (HITOP) Work Group is a federal group that will make recommendations for systematically improving healthcare while reducing healthcare cost. Achievement of semantic interoperability through the use of ontology software in high priority health IT projects will both save money and improve the quality of care. From the local level, to the Regional Health Information Organization level, to the level of states and provinces to the national and international levels, the importance of developing and/or adopting healthcare standards for electronic digital healthcare informatiion systems cannot be overestimated.

Unstructured Information Management Architecture SDK for Healthcare IT applications

Sat, 24 Dec 2005 11:17:37 +0000

IBM’s alphaWorks has announced an update to their Unstructured Information Management Architecture SDK. It’s a fascinating tool for use in our industry, though it was not designed specifically for healthcare applications. As we all know the majority of healthcare information is unstructured in nature but we try to force it into a particular structure because as IT people we like to reduce things to a relational data model where possible. We do this because there are lots of tools and technologies available to store, query, format, report, convert, and maintain relational data.

Inside the Venture Capital process

Fri, 23 Dec 2005 17:28:16 +0000

Although this post is not exactly about healthcare IT, it is about enabling healthcare IT by getting some money for your startup. I talk regularly to entrepreneurs who pitch ideas (which is one of my favorite parts of blogging) and many of them aren’t sure how to get their ideas funded. Having been through several money raising rounds in my previous startups I recommend not raising money from VCs unless you have absolutely no choice; use angel money, bootstrapping, etc.

Software Demonstrations are like watching TV (no, that’s not a good thing)

Fri, 23 Dec 2005 17:12:45 +0000

Will Weider over at Candid CIO posted a great new article: ET and Software Demonstrations. I especially loved what he said about the “Cannit” part of software demonstrations: I know I am trapped in a bad demonstration when a volley begins between participants and demonstrators. Each question begins with “Can it…” Of course each response is “Yes.” Or my favorite “Yes, with customization,” which is vendorspeak for NO. There are so many problems with this approach I don’t know where to begin.

File Compression for Remote Diagnosis

Fri, 23 Dec 2005 16:57:13 +0000

A big challenge these days in remote diagnosis technology is getting those big images sent from one place to another. World Changing reported recently about File Compression for Remote Diagnosis. Jamais Cascio said: Researchers have known for a few years now that applying a mathematical transformation method known as “wavelets” to radiological images can improve the ability of doctors to detect cancer. But Bradley Lucier’s team of mathematicians at Purdue has taken the process to a new level — by using the wavelets method to compress mammogram images by 98%, not only can radiologists still detect cancer better than they can with unmodified images, the mammograms become small enough to send easily over the dial-up computer networks common in poorer parts of the world.

Corporate blogging in Healthcare sector

Fri, 23 Dec 2005 15:35:58 +0000

John Cass recently interviewed me about my thoughts on corporate blogging in healthcare. Matthew Holt was also nice enough to pick up on it. My basic suggestion in the interview was that all healthcare companies (but especially those in IT) should be blogging and setup interactive forums to discuss their products with their customers. Healthcare is ultimately a “local business” so all healthcare is local and it’s very difficult to create “one size fits all” solutions in our industry.

Now we’re talkin’! Bill would hike tax deductions for health IT

Thu, 22 Dec 2005 19:06:47 +0000

Modern Healthcare in their daily HITs newsletter is reporting that Representative Phil Gingrey (R-Ga.) introduced a bill in the House that would increase tax deductions for healthcare providers who purchase IT systems. They reported: The bill, co-sponsored by Rep. Charles Norwood (R-Ga.), Shelley Moore (R-W.Va.) and Scott Garrett (R-N.J.), amends the Internal Revenue Code so that in the first year of purchase, providers would see an equipment deduction go from $100,000 to $250,000 and see an increase in the maximum annual total of deductible property go from $400,000 to $600,000.

Repeat after me: healthcare data models matter

Thu, 22 Dec 2005 14:31:54 +0000

As we all know, healthcare applications come and go but data lives on forever. We’ve seen that since the beginning of the computer industry; when we move from legacy systems into more “modern” architectures, we often leave behind applications but we almost always take along the data into the future. Even though data is so important, we in health IT don’t seem to spend the quality time necessary to structure our schemas and databases in such a way as to make it easier to maintain in the future.

Web Portal Tracks Health IT Interoperability Projects

Wed, 21 Dec 2005 18:49:27 +0000

Bob Burns at HITSphere reports: Web Portal Tracks Health IT Interoperability Projects.

Consumer generated content creates new brand management challenges for life science companies

Wed, 21 Dec 2005 18:37:01 +0000

John Estafanous makes some good points in his article at Medical Marketing about how blogs are creating fits for healthcare companies: Consumer generated content creates new brand management challenges for life science companies. Of course, I think this is a good thing. The more empowered consumers are, the better quality product they’re going to receive at the lowest possible price.

Access control in medical/clinical IT systems

Tue, 20 Dec 2005 19:48:04 +0000

Leo Baschy’s an access control and security specialist who is working on describing and designing systems that are easy to use but remain secure. One of the things that we all know about is that the more secure a system is with all its various levels of access control, the more difficult it is to assign the right controls. It takes special UIs and screens to make role assignments, permissions settings, and related configuration.

Physician IT Skepticism: Over at Last? Humbug!

Mon, 19 Dec 2005 02:32:03 +0000

There’s an interesting article at The Medical Blog Network about Physician IT Skepticism perhaps diminishing a bit. Having been in the physician IT game during the dotcom era I still have nightmares about how hard it was to convince docs to part with their money for absolutely nothing in return. We tried and tried to convince them to try our software that had only been used by a few docs and that they should trust us that it would work for them.

Could ADT’s Remote Monitoring Products become A Platform?

Mon, 19 Dec 2005 02:16:04 +0000

Tim at Medical Connectivity Consulting reports about ADT’s forthcoming Remote Monitoring Products. As I was reading it, I kept thinking that if it was not just a service that they provided but a platform for delivery of new HIT applications connected to patients at home, what types of applications would be most useful? I mean, if we had the ability to constantly monitor patients at home, what new and innovative kinds of new HIT applications could we develop?

Hospital to txt message its patients

Sat, 17 Dec 2005 16:35:02 +0000

Victor at HITSphere reports Hospital to txt message its patients. This is a great example of how simple tools like using email and now text messaging can save costs without introducing much new IT infrastructure. Of course, in the USA we’re still charged for text messages on our mobile phones but overseas they’re usually free (and consequently in heavier use).

HITSphere Health IT User Community site is live!

Fri, 16 Dec 2005 17:27:27 +0000

For the past month I’ve been talking to many readers, vendors, government folks, and other bloggers and based on their input I’ve put together an open, grass-roots, health IT and medical informatics community site. The HITSphere site, which has been just a single-page launch site for those wanting to get learn more about the health IT blogosphere, has been live for about a month and I’ve gotten great feedback. Oh, and lots of people are using the custom health IT specific search engine available on the HITSphere main page and it’s getting better results than Google alone (there’s even a comparison now).

UPI reports IT-related deaths highlight tech needs

Thu, 15 Dec 2005 21:41:38 +0000

As I predicted a few days ago, calls for health IT regulation are now forthcoming. UPI recently report IT-related deaths highlight tech needs.

Errors at the speed of light

Thu, 15 Dec 2005 14:13:36 +0000

Physician Executive published a nice article entitled Errors at the speed of light this past summer. It’s a good lesson, from a Physician’s point of view (Russell Davignon), of CPOE and EMR deployments. Russell started off talking about the existing state of the HIS: Some older physicians were not so enthused and my partner of 25 years, who was nearing 70 when he retired in 2000, still had not learned even the fundamentals of the Meditech system we used when he passed from the practice scene.

Windows Mobile: Development platform for health enabled Smartphones

Thu, 15 Dec 2005 03:32:11 +0000

Dr. Crounse, Healthcare Industry Director for Microsoft, writes about Windows Mobile: Development platform for health enabled Smartphones. He says: The cell phone, and particularly Smartphones running Windows Mobile, may be the perfect platform for applications such as remote medical monitoring, home screening tests, “lite” telemedicine visits, medication management, patient education and more. Software developers should take note of the tremendous potential for cell phones/Smartphones in healthcare. Government and insurers should be thinking about reimbursement mechanisms for the kinds of healthcare services these devices will enable.

CPOE studies generate buzz

Wed, 14 Dec 2005 18:53:08 +0000

I was interviewed by Andis Roberznieks of Modern Healthcare in his latest article entitled CPOE studies generate buzz. It was about my thoughts on the Cerner CPOE study that I wrote about a couple of times last week.

Alexa (Amazon) opens up API, lets use it for Health IT

Tue, 13 Dec 2005 16:09:46 +0000

Alexa (the search engine) is making its data available on the Amazon.com Web Services platform, and it will open up many uses for healthcare IT entrepreneurs who can use 5 billion pages of information at their disposal or would like to host their own applications in the Amazon server farm. Granted Alexa has absolutely nothing to do specifically with healthcare, but the new web service can be used in some interesting cases for vertically oriented search engines.

Can doctors ever learn to love the EMR?

Tue, 13 Dec 2005 15:06:34 +0000

Matthew wrote an article recently entitled Can doctors ever learn to love the EMR?. As interesting as the article was, the comments it generated were even more interesting. What some of the readers wrote is worth reviewing: Allan wrote: One hypothesis that needs to be considered is that the first “wave” of EMR/CPOE implementations were led by medical organizations that already had their “act together” and that the addition of a tool (the EMR) designed to enhance the specific operating environment in which those organizations provide care.

Hospital CEOs and Boards on IT

Mon, 12 Dec 2005 16:16:54 +0000

The Deloitte Hospital CEOs Survey has been released. There are some very interesting results from an IT perspective: 5% of Boards of Directors believe IT is a concern (whereas 66% believe financial viability is a big concern) 22% of CEOs believe additional IT infrastructure is the second greatest need in healthcare industry after coverage for the uninsured (63% believe that) 27% of CEOs believe the Internet will have a big impact on medicine in the next 2 years.

Will NHIN cause EMRs and health IT systems to become another government entitlement program?

Sun, 11 Dec 2005 16:59:28 +0000

In a routine visit to my primary care (PC) doc last week I was noticing how his office worked versus how one of my specialists’ (GI) office worked. In my specialist’s office they were computerized both in the front office as well as in clinical workflow using EMR software. So, I asked my PC doc about when they might start using an EMR since they were already using billing software in their front office.

Impact of Cerner’s CPOE study about increased mortality will likely be more regulation

Sun, 11 Dec 2005 01:06:42 +0000

Yesterday I spent some time being interviewed by reporters about the impact of the CPOE study (about Cerner) that I reported on a few days earlier. One of the reporters asked a great question: what will be the impact of this negative study? My answer was two fold. One was that I didn’t see any big impact on Cerner itself because any objective reading of the Pediatrics article would see a few flaws in the study (which I also elaborated on at length).

Pitfalls of HL7 3.0 implementations

Sat, 10 Dec 2005 03:19:16 +0000

Now that HL 3.0 is live lets hope that vendors and hospitals start to use the single object model, RIM, and XML syntax. However, as new implementations come down the pike they’ll eventually run into some problems which many other early adopters have encountered. The HL7 UK site reports that over the past year Rene Spronk has been collecting notes about HL7 v3 implementation issues discovered by early implementers, notably in the UK and in the Netherlands.

Healthcare IT Discussion Forums

Sat, 10 Dec 2005 00:32:07 +0000

There have been listservs and mailing lists that discuss health IT topics, especially those specific to a vendor like IDX, Cerner, Epic, or Siemans. In fact, user groups have been around forever that discuss their favorite topics (or rants) about their favorite vendors (or those they hate). However, searching those kinds of mailing lists is a bit tough and navigating their topics is also difficult. Discussion boards and forums (fora?) have been cropping up for health IT and I just ran across another one today.

Are you a healthcare firm’s CIO, CTO, director of IT, or other high-level IT executive?

Sat, 10 Dec 2005 00:07:20 +0000

If so, get a free copy of Tim’s HISTalk Yearbook (MSRP is $40) just for filling out a short questionairre. The HIStalk CIO Field Report is a great way for the blogosphere to understand what’s most important to you as a leader in health IT. Spend just a few minutes filling out the form and get a great, free, gift (Tim’s HIStalk Yearbook) just in time for the holidays.

Tracking HIPAA complaints continued

Fri, 09 Dec 2005 23:36:08 +0000

After my article about tracking of HIPAA complaints and the current figures, two healthcare knowledgable lawyers, Robert Coffield and Alan Goldberg were gracious enough to send some specific statistics. It turns out that the topic of HIPAA complaints numbers was actually discussed in a legal listserv and here’s what Robert had to say about it: I thought I would share a post that appeared on the American Health Lawyer’s listserve a couple of days ago.

IEEE, AMA, and 8 other associations join forces to work on standards to accelerate HIT adoption

Fri, 09 Dec 2005 22:58:56 +0000

Before you roll your eyes at YASE (yet another standards effort) take a look at this article at IEEE: Medical Records: From Clipboard To Point-and-Click. I’m biased (I run a local IEEE Computer Society chapter) but I think this effort might have some legs. The official word is that the IEEE has joined forces with eight other medical and engineering societies to form an umbrella consortium, the Biotechnology Council. The council’s primary goal is to standardize everything from medical terminology to networking protocols so that medical records can be stored electronically and sent instantly anywhere in the world — all with absolute privacy, security, and understandability.

Medical Usability: How to Kill Patients Through Bad Design

Fri, 09 Dec 2005 05:33:09 +0000

There’s been a lot of discussion on various blogs about the Cerner CPOE article (where there’s a claim about increased mortality rates because of it). Jakob took a stab at tackling medical software usability in Medical Usability: How to Kill Patients Through Bad Design. It’s not terribly informative nor is there much new in there (the main information comes from a JAMA article), but at least it’s a start. I’m thinking about doing a usability study on existing medical and health IT software.

What’s wrong with health care IT

Thu, 08 Dec 2005 01:50:58 +0000

Matthew’s got an interesting article on What’s wrong with health care IT. I’m not sure I completely agree that just because there are 45 other options out there that the 46th one won’t be useful, but it’s true that we in health IT do sometimes like to reinvent the wheel. And, it’s not always bad — sometimes the reinvention process does create something useful. I don’t recommend building technology instead of buying for hospitals but given that there’s no such thing as a thoroughly succesful PHR we can hardly blame people for thinking they could do it better.

Phreesia is a great example of consumer driven healthcare technology done right

Thu, 08 Dec 2005 00:28:28 +0000

One of my favorite pastimes as a health IT pundit is reviewing new technology before it hits the streets or becomes popular. Last week I had the pleasure of speaking with the founders of Phreesia, a company focused on improving the patient experience in Doctors’ offices waiting rooms. The idea is simple but effective: instead of reading a magazine while they’re waiting, healthcare cosumers (some people call them patients) are handed a free Phreesia WebPad where they can provide their demographics, chief complaints, and other very basic registration information and based on what they tell the WebPad it will show them web pages and drug information related to their symptoms.

Tracking of HIPAA complaints filed

Wed, 07 Dec 2005 15:42:41 +0000

A reader e-mailed a question this morning: Do you know where I can find up-to-date data on HIPAA complaints filed? I’m trying to research current Privacy complaints submitted by category and resolution. I spoke with my friend Bob Burns, who’s about as knowledgable a health IT expert there is, and he said that the original HIPAA law did not mandate any enforcement (although it did specifiy penalties) so there is no real HIPAA enforcement bureau yet.

Splunk for Healthcare is making more sense

Tue, 06 Dec 2005 20:43:10 +0000

A little while ago I wrote about using Splunk, a nice IT systems log aggregator and search engine, in the healthcare sector. I just spoke with the product manager in charge of the tool at Splunk and I liked what I heard even more: they have a solid design, good APIs, and an open approach to accepting almost any kind of ASCII data and creating a searchable index and relationships between data.

Increased mortality reported after CPOE implementation

Mon, 05 Dec 2005 22:16:13 +0000

Scary article of the week: Increased Mortality after CPOE Implementation. It concluded the following: We have observed an unexpected increase in mortality coincident with CPOE implementation. Although CPOE technology holds great promise as a tool to reduce human error during health care delivery, our unanticipated finding suggests that when implementing CPOE systems, institutions should continue to evaluate mortality effects, in addition to medication error rates, for children who are dependent on time-sensitive therapies.

Is there a Healthcare IT bubble?

Mon, 05 Dec 2005 16:31:03 +0000

I’m not sure that it’s ever possible to have a health IT bubble because the money amounts are so tiny in comparison to other bubbles; however, Tim Gee posits some good points about it in his post from today.

We need a Central Bank and credit reporting bureau equivalent for healthcare

Sun, 04 Dec 2005 17:53:33 +0000

Investors Business Daily reports a cure for health IT woes. Yes, the previous statement is a bit sardonic but it’s interesting that IBD would even mention a “cure” for what plagues the HIT industry. They start the article with: …when it comes to health care, most people suffer a system rife with antiquated record-keeping, slow communications and costly manual labor for mundane tasks. It’s a pain for patients, doctors and insurers alike.

Could everybody’s ADT system use the same database schema?

Sat, 03 Dec 2005 17:30:39 +0000

Tim at HISTalk poses a poingnant question: Could Everybody’s ADT System Use the Same Database Schema? Some excerpts: What I was really thinking about is the idea that the database design tells you how the application works. If that’s true, then what technical functions of the vendor add the most value? Is it database design, GUI design, algorithms, content, or something else? If our vendor’s competitor got a copy of the schema I was looking at, would it really reveal any proprietary secrets or otherwise turn on their lightbulbs with great ideas to change their own app?

Technology for privacy of medical consultations

Fri, 02 Dec 2005 23:33:31 +0000

Kevin reported about Privacy for phone calls, privacy for medical consultations. Fascinating.

Will puts a smackdown on CPOE

Fri, 02 Dec 2005 23:29:13 +0000

Will Weider, one of my favorite healthcare CIOs, puts a smackdown on CPOE in his recent CPOE Rant. Precious.

Health and Medical Resources Directory

Fri, 02 Dec 2005 15:58:26 +0000

Just ran across this nice Health and Medical Resources Directory. They say: This Healthcare Resources directory provides over ten thousand links to healthcare providers, physicians, medical centers, hospital and other health related services. It’s missing a search engine but otherwise it’s pretty nice.

One table to contain all lookup data is not a good idea

Fri, 02 Dec 2005 14:59:33 +0000

Elyse posted a design pattern (antipattern?) in AntiClue’s One table to contain all lookup data article and followed it up a few weeks later with an example. I wrote an article called Repeat After Me: Healthcare Data Models Matter which was published over at IBM’s HealthNex and Tim’s HIStalk blogs because I wanted their audiences to hear what I wanted to say on the matter. In that article I said that you can not treat databases as a file cabinet â€“ just letting your application toss whatever is necessary into a bunch of tables and then organizing it later is a recipe for disaster.

A reader asks about how to evaluate EMRs & EHRs vendors

Fri, 02 Dec 2005 02:11:05 +0000

A reader posed the following question this morning: I am an MD in a 350 physician multispecialty medical group. We are owned by a multi-hospital system that just signed a contract with McKesson to provide new enterprise level Software for all of the hospitals, but did not buy any ambulatory EMR. I’ve been assigned to a committee to preview various ambulatory EMRs Specifically for our physician group. I know that McKesson has a product Named Horizon.

Notes from the HIMMS “Enabling e-Health for RHIOs” Webinar

Thu, 01 Dec 2005 22:07:26 +0000

I attended the HIMMS Enabling e-Health for RHIOs webinar, presented by Sun Microsystems, this afternoon. Overall I found it informative, not too vendor-preachy, and generally filled with practical knowledge. Mike Haymaker and Wayne Owens from Sun and Dr. Steven Carson, CMO of San Diego’s CMS, presented the deck. Since I’m a technologist who happens to know healthcare informatics (not a healthcare person looking to learn about technology) I found the two Sun folks knowledgable but I really like what Dr.

M&A in the Healthcare IT world reviewed

Thu, 01 Dec 2005 14:39:44 +0000

Matthew’s got a good health IT article M&A in the Healthcare IT world reviewed on his blog today. Worth a look.

CNN reports huge growth for tech in health sector

Thu, 01 Dec 2005 14:37:45 +0000

CNN is reporting the obvious in their _ Huge growth for tech in health sector_ article. Some highlights: Worldwide, the healthcare information technology market is estimated to be worth more than $50 billion a year, and industry executives — lining up for a slice of the action — told a conference this week its growth would be in double digits for the foreseeable future. And, though it’s not new to anyone reading this blog regularly, they say:

Thanks for the nominations, everyone

Wed, 30 Nov 2005 19:32:53 +0000

The folks at MedGadget asked for Medical Blog Awards nominations and about 6 different readers nominated this blog for an award. I’m flattered, and I thank all of you who thought about me :-).

Technology for networked medical devices

Wed, 30 Nov 2005 19:21:16 +0000

It is very common for networked medical applications that need to work consistently even when momentarily disconnected. I ran across an interesting technology at IBM called FluidSync. It seems to be helpful in those situations when a user needs to use an application across several devices and be able to maintain the application state across the devices seamlessly. For example, if a nurse is moving between several rooms across several computers she would be able to run the same application across the machines and see the same data across the machines while she moves.

Tax refunds and credits for R&D investments

Wed, 30 Nov 2005 19:14:08 +0000

I spoke with the BizDev manager of Fortis TCS today. They are an interesting company that focuses on the tax side of technology. That is, if you spend money on R&D and would like to get tax credits (refunds of what you’ve already paid in taxes) then they’re a group you should get to know. Fortis comes in and talks with you for 30 to 60 minutes and can then give you an idea of how much money you might be able to get back from the government in the form of tax refunds based on R&D expenditures.

Cerner vs Epic from a customer’s point of view

Wed, 30 Nov 2005 12:56:39 +0000

HISTalk mentioned a recent Cerner vs. Epic discussion on their forum. It’s a wonderful example of what an end-user or customer view of a product comparison should look like. I like the idea of forums to ask questions publicly (I get emails asking questions often which I post answers to online sometimes). I’m thinking of adding forums at my new HITSphere health IT blogs aggregator and specialty search engine. [Let me know what you think][4] either via email or comments here.

Open source online health record management

Wed, 30 Nov 2005 12:45:02 +0000

A reader sent in an email asking “Is there an online health record that is open source or one that I can private label?” The answer is generally yes. Here are just some of the options for open source health records management: OpenEMR ClearHealth MirrorMed FreeMed MedSphere Note that none of the above choices is good to just private label and start a PHR or EHR without some modifications but there are at least FOSS products that won’t require you to start from scratch.

Microsoft’s eating their own dogfood again: this time for a health technology cause

Tue, 29 Nov 2005 00:20:13 +0000

Over at Microsoft, reports HealthBlog, they are using their tried and true “eat your own dogfood” approach to open the lines of communication between docs and patients by getting their own employees to be the early users of the system. Dr. Crounse writes: …we learned that patients really like being able to correspond with their physicians by e-mail, and physicians enjoy providing clinical cognitive services electronically when they get paid for doing so.

A Healthy IT Outlook

Mon, 28 Nov 2005 20:36:45 +0000

Peter Coffee, one of my favorite writers because he actually knows what he’s talking about, wrote a column entitled A Healthy IT Outlook in which he opines that the medical sector holds the key to innovation and growth. Specifically, he says: Health care technology and practice have long been sources of some of the best case studies available to eWEEK’s analysts. Medicine adopts new technology aggressively and has a tradition of extensive discussion and peer review of new techniques, whether we’re talking about emergency readiness or hospital management or international assistance.

Consumer oriented healthcare using kiosks, portals, and bedside devices

Mon, 28 Nov 2005 16:03:47 +0000

Healthcare Informatics has a good article on Healthcare Customer Service using kiosks, portals, and bedside carts. The move towards treating the patient as a true customer which has to be won over and catered is requiring new techniques and technologies; the old model of a patient who has no choice but to come to your facility is no longer the case. Customer service, which has long held a back seat in our industry, is now more important than ever and as consumers continue to be empowered using physician ranking websites, hospital scoring companies, and specialty search engines it will be become paramount if a provider organization is to thrive.

The 2005 Medical Weblog Awards

Mon, 28 Nov 2005 14:22:43 +0000

Medgadget just announced the call for nominations for The 2005 Medical Weblog Awards.

The Disaster-time Health Record (DHR)

Sun, 27 Nov 2005 22:28:48 +0000

It’s time to add a new acronym to the long list of medical records-related acronyms: the DHR. The disaster-time health record is similar to a personal health record (PHR) except it’s meant to maintain an electronic record that is concise and simple enough to be used by emergency personnel in times of natural or other types of disasters (or even personal disasters, I guess). We should have EMRs managed by care providers, PHRs managed by individuals themselves, and DHRs managed by governments and disaster relief services like Red Cross.

Wireless home-monitoring network for recuperating hospital patients

Sun, 27 Nov 2005 21:40:00 +0000

I read about an idea for a wireless home-monitoring network for recuperating hospital patients. Apparently if someone can come up with a basic prototype thereâ€™s money in VC circles available to pay for it. Hereâ€™s the relevant snip from the article: WHAT THEY WANT: A wireless home-monitoring network for recuperating hospital patients. WHY IT’S SMART: No one likes extended hospital stays. Not patients, not hospitals, and not insurance companies paying bills that can exceed $5,000 a day.

iHealthRecord makes a good case for PHR

Fri, 25 Nov 2005 23:38:13 +0000

Christina over at Christina’s Considerations writes about Personal Health Records. She points out Medem’s new iHealthRecord site, which seems like a great PHR initiative. This PHR competes with the likes of OnFile, MyMedicalRecord.com, MyPHR.com, and numerous others. The market is not starting to mature yet because the initial players are still basically throwing darts at the wall to see what’s sticking. Until a “name brand” PHR appears (like my suggestion for American Red Cross to become a player) we’ll continue to see widely varying implementations.

RxWise tries to reduce medication errors

Thu, 24 Nov 2005 20:34:49 +0000

Check out RxWise. It’s supposed to analyze your medical history and help prevent interactions between prescription, over-the-counter and herbal medications, including drug allergies. You manage all your meds online (yourself) and then your pharmacist and docs can be given access so that it helps reduce prescription errors. There is also an option to get a USB thumb-drive type device. Here’s what they say about that: If you sign up for the Flash Drive version, weâ€™ll send you a thumb-sized USB Flash containing all of sophisticated, yet easy-to-use risk-assessment software.

How about a Splunk for healthcare data?

Wed, 23 Nov 2005 04:54:31 +0000

I blogged about Splunk earlier today. Splunk automatically organizes various types of IT data (logs, configuration files, message queues, JMX, SNMP and database transactions) into events. It then classifies these events and discovers relationships between events of different kinds. Events are indexed by time, terms and relationships. It then tosses on a search engine so you can look for patterns in realtime or much later. Now, healthcare IT builds on top of regular IT so Splunk is a fascinating product for HCIT purposes and you should look at putting it to use as is.

CHCS II is dead; long live AHLTA!

Wed, 23 Nov 2005 04:40:54 +0000

What’s in a name? Quite alot, apparently. Some excerpts: From now on, the Composite Health Care System II (CHCS II) is to be called AHLTA. DOD officials said AHLTA stands for Armed Forces Health Longitudinal Technology Application, however, the system should simply be known by the acronym. Winkenwerder said he did not like the CHCS II name because it suggested that the system was not No. 1. AHLTA, which will hold the health records of 9.

Indoor Positioning for Healthcare from Radianse

Tue, 22 Nov 2005 18:56:10 +0000

Indoor Positioning Solutions (IPS) is analogous to GPS in an indoor space. The folks at Radianse combine active-RFID and location information to enable systems, applications, devices and clinical spaces to automatically initiate actions based on circumstances or events at a point in time. Here are some of the things they claim can be done with their system: Real-time asset location â€“ right equipment in the right place at the right time Improved preventive maintenance/recall management Reduce time searching for equipment Improved cost capture Information on utilization rates Rental and lease reduction programs They say they can also help keep track of people to:

Using dictation, podcasts, and Transcribr podcast transcriptions for clincal records

Tue, 22 Nov 2005 17:06:42 +0000

Most of the medical community is probably not terribly interested in podcasts yet but I suspect that digital recordings that many physicians make for medical records can be turned into transcriptions and easily inserted into medical records using upcoming services like Enablr’s Transcribr. Now, they’re not super-cheap, but the idea is great (especially for $1 a minute which is cheaper than many full-service bureaus). As we already know, transcriptions in the medical/clinical world are some of the largest portions of healthcare budgets so anything that can help reduce that cost and burden will be more meaningful than new software.

Use RSS and SSE for healthcare data synchronization in masterless environments?

Tue, 22 Nov 2005 15:16:43 +0000

RSS is a means to syndicate content unidirectionally — for example, when I create a new article here and you subscribe to my feed you will get news about my new publication in your feedreader. Microsoft’s Ray Ozzie (inventor of Lotus Notes and Groove) announced that Microsoft has extended the standard with SSE, which is a â€œspecification that extends RSS from unidirectional to bidirectional information flows.â€? Some elaboration on the technology comes from Ray:

Real-World RHIO

Mon, 21 Nov 2005 15:43:31 +0000

A friend of mine recently sent a link to an interesting article on RHIOs. From the Journal of AHIMA, Real-World RHIO: A Regional Health Information Organization Blazes a Trail in Upstate New York. Their description: By distributing costs and benefits among providers and payers, a regional physician association is creating a data exchange network with an ambitious goal: interoperable EHR systems in every physicianâ€™s office. You may also be interested in these sepcial IDC reports on RHIOs and RHIA guides:

How to dip your feet into offshore custom development of medical/clinical software

Mon, 21 Nov 2005 02:39:24 +0000

If you’ve been intrigued with the offshore outsourcing movement in the software development industry (such as R&D and operations/maintenance going to Ireland, India, and China) then you’re not alone. With everyone in healthcare IT looking to cut back on costs, it’s only natural that CEOs, CFOs, and CIOs would start to entertain offshore outsourcing options. But, where do you start? Who can you trust? I’ve been using an auction-style service known as RentACoder.

Visual depiction of how far we’ve come with medical/clinical records management

Sun, 20 Nov 2005 16:48:42 +0000

We’ve made great strides in hospital buildings, patient rooms, surgery centers, and diagnostic tools. Doctors from the 1930’s may not recognize many of the tools and facilities we use today. Now, how far have we come along in medical and clinical records management? We have much cooler looking file folders and storage cabinets! I don’t think any doctors from the 1930’s would have any problem using the new folders, though. 🙂

ConceptDraw software for medical diagrams, healthcare plans

Sat, 19 Nov 2005 18:09:51 +0000

Visio is a great tool for general diagramming but when it comes to medical and healthcare-specific diagrams a better tool is ConceptDraw HealthCare Management Suite. The stuff it’s good for includes (this comes from their website): Medical diagrams and charts Medical illustrations and graphics Teaching and education materials Medical training diagrams and drawings Anatomical drawings for medical notes Visualizing complex medical issues Flowcharts, orgcharts Healthcare plans Medical project plans To-do lists for stuff Process flow charts for presentations Numerous reports, calendars and timelines Cause-and-effect diagrams Floor plan of your hospital If you know of other software that does similar things in a better way, let me know.

Open source tool for connecting disparate legacy medical/clinical databases

Sat, 19 Nov 2005 16:29:12 +0000

Since most of us in IT spend at least part of our time combining data from multiple databases, it might be worth taking a look at an open source toolkit called Hydrate that eases the process. From their description: Hydrate is a Java tool that provides for fast efficient and error-free transformation of data between three different representations: relational databases, objects in an object-oriented programming language and extended markup language (XML).

How to ensure IT project failure

Sat, 19 Nov 2005 16:13:11 +0000

Will at The Candid CIO wrote a great article today: “This is no way to run a project”. Having been in my share of demos that have no defined purpose or evaluation criteria I had a great chuckle.

How to stop reinventing role based access control (RBAC) in medical/clinical apps

Sat, 19 Nov 2005 01:29:48 +0000

Every useful medical and clinical application has security requirements and most programmers end up implementing some sort of Role-Based Access Control (RBAC). Every couple of months I’m called in to do a code review or architecture assessment for the security components and it surprises me that everyone keeps reinventing the wheel when there is good thought leadership in the area. If you’re writing secured applications and you need help with role based access control, please do yourself and your programmers a favor and review the NIST Role-based Access Control research materials and standards guidelines.

My Service Oriented Architecture (SOA) presentation from last night

Fri, 18 Nov 2005 17:18:15 +0000

Last night I presented my briefing on hype, pitfalls, and opportunities associated with Service Oriented Architecture (SOA) to the Nothern Virginia Chapter of the IEEE Computer Society. Many people asked for a copy of the briefing/presentation so here it is: Enabling the Service Oriented Enterprise – Overcoming the hype, misconceptions, and pitfalls of SOA If you attended the meeting last night, please feel free to leave me comments on what you liked, what you didn’t like, and whether it was helpful.

Another Healthcare IT blog you might like

Thu, 17 Nov 2005 18:39:39 +0000

I found the following articles interesting. I especially like how the author has a “why it matters” section for each entry, trying to bring the subject home and telling you why you should care. Nice. British NHIN project failing FDA puts standardized drug information online JCAHO will not sell data analysis services PDAs increase antibiotic efficiency Ohio HIPAA violation

68% of CEOs report purchasing of hospital IT systems as major capital need over the next 5 years

Thu, 17 Nov 2005 14:29:53 +0000

Tim at Medical Connectivity reported yesterday about IT being an important part of most hospital CEO’s concerns and prioritites. An important remark he made was: Hospital boards are focused first on financial viability (66%), information technology infrastructure ranked second (at 22%). Hospital CEOs are investing in programs to improve quality. Specific programs are chosen in large part for their ability to generate revenue enhancements and/or reduce costs. Time to visit your local hospital CEO and help him part with his money :-).

Get ready for HL7 CDA-based attachments to ASC X12 claims

Thu, 17 Nov 2005 14:17:46 +0000

With all the recent talk about eHealth 2.0, EMRs, PHRs, and consumer driven healthcare we may sometimes forget that some of us are involved in the dirty, rotten, tiresome, and difficult job of getting their firms paid for services. HIPAA did a decent job of standardizing electronic claims with the ASC X12 837 transaction sets and payers and clearinghouses were good about supporting it but one big thing was missing: attachments for documents required to prove the rendered services.

Give Ruby on Rails a shot for medical/clinical web applications

Thu, 17 Nov 2005 02:34:28 +0000

Most people in the healthcare and medical/clinical applications universe are aware of PHP, Java, perl, .NET, C#, and especially Mumps for developing systems. However, most of you may not be familiar with a relatively new scripting language called Ruby and a full-stack framework called Ruby On Rails. If you’re developing quick-turnaround web applications to connect to existing or legacy applications you may find that working in Rails is a very good way to get quick and dirty applications completed.

Dead Healthcare Workers Do Not Provide Good Patient Care

Thu, 17 Nov 2005 02:04:56 +0000

Interesting article on bird flu that doesn’t have anything to do with IT: Dead Healthcare Workers Do Not Provide Good Patient Care.

Our badge of honor: U.S. leads way in medical errors, costs

Thu, 17 Nov 2005 00:46:48 +0000

Reuters recently reported about a study that concludes U.S. leads way in medical errors, costs: Patients in the United States reported higher rates of medical errors and more disorganized doctor visits and out-of-pocket costs than people in Canada, Britain and three other developed countries, according to a survey released on Thursday. Thirty-four percent of U.S. patients received wrong medication, improper treatment or incorrect or delayed test results during the last two years, the Commonwealth Fund found.

GE Healthcare Unveils Algorithms That May Help Physicians Predict Risk of Sudden Cardiac Death in Patients

Tue, 15 Nov 2005 19:56:00 +0000

RedOrbit reports GE Healthcare Unveils Algorithms That May Help Physicians Predict Risk of Sudden Cardiac Death in Patients. An excerpt: GE Healthcare, a unit of General Electric Company (NYSE:GE), announced today that the company has developed two new algorithms that, when used together, may help physicians predict whether a patient is at risk for sudden cardiac death (SCD). And, for the first time, the algorithms can be used in combination with technology that is portable, making diagnostic tests available to patients anytime, anywhere.

Leveraging technology to make doctors more productive

Tue, 15 Nov 2005 19:51:18 +0000

Dr. Aniruddha Malpani, a practicing Physician in India, writes about Leveraging technology to make doctors more productive. There are some good ideas in the post, but others that I don’t agree with (Dr. Malpani doesn’t exactly understand our world). It’s worth a look, though, because it’s an outsider’s (Indian) view of our healthcare system.

Taking patient-centric architecture to the next level

Tue, 15 Nov 2005 19:43:02 +0000

The Patient’s Home: The New Healthcare Hub audio conference announcement The Patient’s Home: The New Healthcare Hub, a December 6, 2005 audio conference, will examine how healthcare organizations are using home monitoring technologies to improve care management and reduce healthcare costs. Healthcare quality and access can be improved and healthcare costs reduced by moving care management functions away from provider offices and institutions and to the patient’s home. Home monitoring technologies move care management processes away from costly centers of care.

Sun Offers Item-Level RFID for Pharmaceuticals

Tue, 15 Nov 2005 15:55:28 +0000

If you’re looking to get involved in Healthcare RFID, here’s an interesting article: Sun Offers Item-Level RFID for Pharmaceuticals.

Docs buying medical record systems in bulk

Tue, 15 Nov 2005 15:48:13 +0000

DoctorBlogger says: Physician practices are on the information technology hot seat these days. Everyone from industry trade groups to the federal government has announced initiatives to encourage them to adopt electronic medical records. Moreover, the technology has advanced enough to merit the investment, even by penny-pinching, under-automated medical groups. But getting EMRs into the exam rooms of the more than 470,000 office-based physicians could take decades. Imagine each office deciding on its own whether and when to adopt an EMR, handling its own vendor search, and orchestrating its own implementation.

10 make or break steps to CPOE

Tue, 15 Nov 2005 15:08:08 +0000

Check out HealthLeaders Magazine’s November Cover Story: Bring Order to CPOE With 10 Make or Break Steps (and 5 myths). Nothing groundbreaking but it’s a good overview into computerized physician order entry system deployment. Shocker: it’s a people problem, not a technology issue! 🙂 One universally good point they make: If CPOE masters agree on one strategy, it’s this: To succeed, a CPOE implementation must be the top priority initiative across the hospital.

We’re in the era of e-Health 2.0

Tue, 15 Nov 2005 14:49:18 +0000

There’s been a great deal of discussion in the computing and media community about Web 2.0. Web 2.0 is about the Internet becoming a platform for applications and not just a delivery vehicle for information. New technologies like AJAX are providing far more interactivity without the wait, services like Google Maps show that sophisticated web based apps are no longer tied to thick applications that have be download or provided on a CD.

Consumer-driven healthcare provides new opportunities for legacy HCIT vendors

Tue, 15 Nov 2005 14:26:18 +0000

According to Red Herring, 46% of U.S. adults have researched a medical condition online. 36% have researched a drug or medical condition online. 12% have researched a doctor or hospital online. Why is this important? Because consumer-driven healthcare is not a fad nor a myth – it’s real, it’s here to stay, and Forrester says it’s a $16B industry. Consumer healthcare tools have been provided so far by new companies, not legacy providers.

What on earth does Southwest Airlines have to do with healthcare?

Tue, 15 Nov 2005 03:05:10 +0000

In the time I’ve spent in healthcare and clinical informatics I’ve spent my fair share of time with physicians. Although my experience with most physicians has been positive, there are always horror stories about how docs are unfeeling or just don’t care about patients. I’ve found Dr. Woods writings refreshingly clear and informative about how physicians think. His recent article What on earth does Southwest Airlines have to do with healthcare?

Use of Waterfall, Agile, XP, Scrum software development methodologies in healthcare apps

Mon, 14 Nov 2005 19:59:03 +0000

I’m conducting a survey on the various software development lifecycle methodologies that may be in use for developing healthcare IT applications inhouse or at vendors. Drop me an email about your company’s choice of methodologies. Do you use an Agile methodology like XP or Scrum or are you using a tried and true Waterfall approach? There’s been a great of movement towards Agile methods in the past few years in my non-healthcare clients but many of the medical and clinical apps don’t seem to be developed that way.

Understanding healthcare technology and clinical systems challenges

Mon, 14 Nov 2005 15:40:24 +0000

There’s some nice content at Health Care Technology. It’s really about healthcare best practices but with an emphasis on how technology can help implement those best practices. Their description of their site: The white papers and solution profiles are a collection of viewpoints on the practices, tools, technologies, and trends that affect health care today. These include patient safety issues, efficiency gains in administering care, and improvements on labor issues by increasing time with patients versus time spent on paperwork, all of which ultimately improve patient care and the financial cost of providing that care.

Healthcare IT Yellow Pages and White Papers catalog

Mon, 14 Nov 2005 15:18:39 +0000

Check out the Healthcare IT Yellow Pages and White Papers catalog. Here are some more white papers.

Does the USA nursing shortage provide any technology opportunities?

Mon, 14 Nov 2005 15:07:21 +0000

The University of Maryland’s Center for Health Work Force Development says we will be short 1,000,000 nurses by 2015. The causes for the shortages are well known and documented; however, the solutions are not very forthcoming. I’ve been involved in projects that tried to bring in nurses from foreign countries like Phillipines, Pakistan, and India through the U.S. Immigration’s H1-B program but that’s not a complete solution either. Although nursing is a service sector that we can’t automate ourselves out of, are there any ideas that you’d like to share for specific technologies or solutions that may help relieve the nursing shortage pressure?

Secrets of an HCIT vendor sales guy

Mon, 14 Nov 2005 12:49:13 +0000

One of my favorite bloggers, Tim at HIStalk, has blogged about the healthcare IT sales process from a vendor perspective. I’ve been involved in the sales side as well as the technology side for some time and I agree with most of the stuff the guy Tim interviewed had to say. On selecting which customer to concentrate on: My biggest indicator of a person’s influence in the deal is their level of honesty in the dialog.

Nine Healthcare IT Tech Trends

Fri, 11 Nov 2005 21:02:47 +0000

I’m often asked by people in non-healthcare IT fields about where health and medical IT is headed. With all the publicity health IT is getting these days, lots of my friends want to get into the field but aren’t sure where to start. In case some of you missed the article from earlier this year, Healthcare Informatics talked about that particular topic in Nine Tech Trends, Healthcare IT advances are pulling together to manage an expanding universe.

HL7 Version 3 and semantically interoperable healthcare information

Fri, 11 Nov 2005 20:34:54 +0000

Healthcare Informatics has a good article on HL7 3.0. Many people think that HL7 3.0 is about “XML enabling” HL7 but it’s actually much more than that, especially if you’re interested in semantic integration of healthcare data. From the article: The limitations of HL7 V2.x … and thus the overarching motivations for the HL7 Version 3 framework, can be summarized as unpredictable message semantics and a consequent lack of scalability, particularly across inter-enterprise boundaries.

NIST HIPAA Resource Guide

Fri, 11 Nov 2005 17:50:34 +0000

A few readers wanted some additional details about how to specifically address information security for healthcare IT based on my HIPAA article yesterday. It seems I forgot to mention that we should all review the guidelines provided by the National Institute of Standards and Technology (NIST) in its HIPAA Resource Guide. It’s specific and actionable so it’s a great place to start. Keep in mind though that these standards are very high-level and do not deal with specific security issues for specific systems.

Hospital Impact Weekly News

Fri, 11 Nov 2005 14:19:08 +0000

Tony’s starting a great new weekly series entitled Hospital Impact Weekly News, which he says is “a quick rundown of the 5 most impactful news stories for hospital executives for that week.” I think it’s a great idea.

Interesting privacy/confidentiality problems in Healthcare IT

Thu, 10 Nov 2005 14:30:48 +0000

A student working on a Ph.d thesis on IT security sent me an email last night asking about interesting problems and industry directions for computer security in healthcare IT. He’s interested in applying his knowledge to this area and was asking specifically about privacy and confidentiality. I figured other students or readers might be interested in my answer so I’m answering the question here and others can comment if they can help out further.

Use of Bayesian Networks to Classify Complex Pathologies

Wed, 09 Nov 2005 18:57:20 +0000

John Eberhardt of DecisionQ Corp will be presenting a tutorial entitled Use of Bayesian Networks to Classify Complex Pathologies at NIH tomorrow. If you’re in the DC area, it might be worth attending. Here are the details: DATE & TIME: Thursday, November 10, 2005, 3:00 to 4:30 p.m. LOCATION: NIH Clinical Center (Building 10), Medical Board Room (Room 2C116) SUITABLITY: Anyone interested in the subject matter. NIH CONTACT: Jim DeLeo, 301-496-3848, jdeleo@nih.

Oops! Patient data accidentally leaks through file sharing app

Wed, 09 Nov 2005 14:51:20 +0000

HIStalk reports A senior Japanese officer and hospital manager screws up his file-swapping program, allowing patient data on his PC to be downloaded by MP3 seekers. The file is still bouncing around in cyberspace with no hope of stopping it.

Consolidating and serving live data from medical devices

Wed, 09 Nov 2005 14:09:43 +0000

Tim at Medical Connectivity talks about the state of the market of medical device connectivity providers. It seems lots of folks have forgotten about the IEEE 1073 standard since it’s not getting a whole lot of press these days, but perhaps discussion about the standard needs to get resurrected so that it starts to show up in proposals and RFQs more often than it does. For a more detailed overview of the state of medical connectivity see Tim’s earlier article.

Two of history’s worst software bugs reported to be in medical software

Wed, 09 Nov 2005 00:16:55 +0000

Wired magazine’s History’s Worst Software Bugs article shows two of them were created by the medical software community. Getting on this top 10 list is not exactly a badge of honor, but we can certainly learn from the failings of the past. Wired says the first one occured between 1985 and 1987: Therac-25 medical accelerator. A radiation therapy device malfunctions and delivers lethal radiation doses at several medical facilities. Based upon a previous design, the Therac-25 was an “improved” therapy system that could deliver two different kinds of radiation: either a low-power electron beam (beta particles) or X-rays.

It’s a good time to be in healthcare IT

Tue, 08 Nov 2005 23:55:39 +0000

I’ve been in the healthcare IT industry for a little over 10 years now and I’ve noticed that 2005 feels alot like 1999 in terms of healthcare IT mindshare, reporting, and investments. I think much of the reason for the resurgence in health IT these days is due to President Bushâ€™s Spring 2004 call for the creation of electronic medical records (EMRs) for most Americanâ€™s within 10 years. I was a co-founder of a healthcare dotcom that started in ’98 and was sold back in 2001 (we ran out of money).

Buyer beware: encryption does not mean application security

Tue, 08 Nov 2005 13:10:15 +0000

It’s funny that most of my time during a review or evaluation of web based healthcare IT systems when I bring up the issue of security the salesperson almost always says “yes, we use SSL.” There’s a great of deal of growth in EMRs, EHRs, and other healthcare applications that will be web hosted over a WAN like the Internet or via a VPN. One thing that all IT community members and architects should be very clear about in our world is that SSL (encryption) is not the same thing as application security.

Open Healthcare Framework

Mon, 07 Nov 2005 17:44:32 +0000

The Eclipse Open Healthcare Framework Project was proposed back in June and seems to be a worthy undertaking. They describe the project as: The goal of the Open Healthcare Framework (OHF) is to extend the Eclipse Platform to create an open-source framework for building interoperable, extensible healthcare systems. We also intend to develop a complementary set of exemplary tools. OHF will enable software providers and integrators to cost-effectively create customized offerings for healthcare delivery organizations that comply with government regulations and industry standards.

Disease-specific blogs may be good for patients, providers

Fri, 04 Nov 2005 13:39:16 +0000

Patients have been using consumer-oriented healthcare IT for some time now through popular sites as WebMD and search engines for looking up information. While many of the healthcare websites have forums and chats for patient-to-patient communications, physicians and nurses should try to turn their patients onto disease-specific blogs as a simple way to help their patients stay informed. Here are a few examples, please comment if you know more. Diabetes Mine The Skin Cancer Blog Autism Alzheimers Simple tip for doctors or nurses trying to help their patients with chronic or long-term diseases: invite them to do a search for their specific disease using the Technorati blog search tool (just enter the name of the disease or common diagnosis terminology in the search box).

Attitudes of Americans Regarding Personal Health Records

Fri, 04 Nov 2005 00:20:16 +0000

The Markle Foundation recently released the Attitudes of Americans Regarding Personal Health Records and Nationwide Electronic Health Information Exchange research report. It’s numbers are bit lower than the numbers from the 2004 Harris survey regarding interest in personal health records. I didn’t find the new Markle report terribly revealing nor actionable but I am glad to see that Americans would start to use personal health records if all the stars were aligned properly.

Should we care about EMRs?

Sun, 16 Oct 2005 19:58:13 +0000

Electronic Medical Records (EMR) are getting much press these days, especially since the Bush Adminstration is pushing them as a core of the NHII (National Health Information Infrastructure) in the second term agenda. HHS set aside $50 million for EMR projects in 2004 and included $100 million for such projects in its 2005 budget. Everybody seems convinced that we could save billions of dollars and thousands of lives if only we had electronic medical records in place.

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