Reducing my Digital Burden
Last weekend, I started a process that some may consider regressive. I began deleting my social media accounts to improve the signal to noise ratio in my life.10 years ago I wrote about the importance of social media and building networks of colleagues, collaborators and relationships.During that decade our social norms have changed to the point that we walk off cliffs, text while driving, and document every microsecond of our lives on devices that have become the centerpiece of our waking hours.The problem has gotten so profound that Google has introduced artificial intelligence technology torespond to messaging for...
Source: Life as a Healthcare CIO - September 21, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Third Week of September 2016
The nights are beginning to cool down to the 40 ’s and we’ve doubled up on the straw in the pig barn in addition to tucking them in each night with 3 fleece blankets. In a few weeks we ’ll move them from the Summer Pig Cottage (shaded/east facing) to the Winter Pig Palace (sunny/south facing) and given them their cold weather quilts for sleeping. It ’s hard to imagine the farm without the pigs. Like dogs and geese and they are intelligent, emotionally responsive companions that really brighten our days.The drought continues and we ’ve had only half an inch of rain this month. The apple...
Source: Life as a Healthcare CIO - September 15, 2016 Category: Information Technology Source Type: blogs
Clarifying Certification Requirements for Hospitals
With all the changes happening to Meaningful Use, Quality Measurement, and MACRA in 2016, I ’ve been asked many questions by many organizations to help them plan for the future.As I ’ve said many times, one of the great challenges we have is that the 2015 Edition final rule has an enormous scope extending beyond Meaningful Use with the notion that it can be coupled to every government healthcare IT program. Standards needs to be based on requirements and specific use cases with little optionality, so creating a broadly scoped rule before the use cases are known just doesn ’t work. Although it is my h...
Source: Life as a Healthcare CIO - September 14, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Second Week of September 2016
Hurricane Hermine came and went, dropping only 2/10ths of an inch of rain on the drought parched soil of Eastern Massachusetts. Although we had 20 mph wind gusts, none of the stressed trees were knocked over.We ’re continuing to irrigate our crops using our 60 zones of drip irrigation, while trying to preserve the well. We ’re praying for rain.We ’re always learning at Unity Farm. This week ’s question - can a pig get cyanide toxicity from eating peach pits? Each week we receive the discarded fruit and vegetables from Tilly and Salvy ’s farmstand, feeding them to the pigs, poultry and...
Source: Life as a Healthcare CIO - September 8, 2016 Category: Information Technology Source Type: blogs
The Joy of Mentoring
Since 2016 is the 20th year I ’ve served as CIO, I’ve given a great deal of thought to the various careers I’ve had and the roadmap for the 20 next years of my working life.In my late teens and 20s I was an entreprenuer running a 35 person software company while doing my medical and graduate school training. I was also a winemaker, home builder and engineer.In my early 30 ’s I was an Emergency physician, software coder, and data analyst.In my mid 30 ’s as a CIO, I focused on architecture, high reliability computing, and centralization of IT service deliveryIn my early 40 ’s, I focused on disaster recovery...
Source: Life as a Healthcare CIO - September 7, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - First Week of September 2016
Tropical storm Hermine is approaching New England this weekend and we can only hope we get some drought relief without too much wind. The ferns in the forest crunch like potato chips and the soil around the farm has become hard pack. All the alpaca compost we ’ve mixed into our growing areas helps retain moisture, but with months of little rain, every non-irrigated area is drying out.All of this dry weather has increased predator pressure on the farm. Coyotes now visit every afternoon and we ’ve lost a few chickens. With very limited water and food sources in local forests, the farm ha...
Source: Life as a Healthcare CIO - September 1, 2016 Category: Information Technology Source Type: blogs
The Blockchain Challenge
Early this year, I posted a collaborative discussion about the potential applications ofBlockchain for healthcareAriel Ekblaw from the MIT Media Lab collaborated with BIDMC to actually implement Blockchain medication reconciliation with deidentified patient data.ONC selected it as awinner of the Blockchain ChallengeThe idea is simple. Blockchain was invented to handle financial transactions such as deposits and withdrawls.Medication management is very similar to a bank account. Think of your body as a vault. When a clinician prescribes a new medication, a deposit is made. When a clinician discontinue...
Source: Life as a Healthcare CIO - August 31, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Fourth Week of August 2016
It ’s another “vacation” week for me, which is code for catching up on all business and personal commitments I’ve made over the past few months but haven’t yet completed. The good news is that I ’ll start next week with a clean slate.Google Maps recently updated their survey of Sherborn, so we have a very current view of Unity Farm. Here ’s what it looks like from aboveAnd here ’s Kathy’s hand drawn key so that you can better understand the features in the photograph.As you can see, the farm is a self contained ecosystem with fruits, vegetables, forest, water, and animals. We ’re at th...
Source: Life as a Healthcare CIO - August 25, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Third Week of August 2016
I ’m on “vacation” this week, working remotely from the farm, so no Wednesday blog post, but here’s the Unity Farm update.I always tell my staff that management is balancing scope, time and resources. To much scope and not enough makes resources very grouchy unless they are augmented.The same thing is true about managing a farm. Unless you set a scope that is achievable with the resources you have, the time (defined as the seasons in the farming year), living things, including your own well being, will suffer.As we plan for 2017, something we ’re doing during my slack time this week, we’e set a...
Source: Life as a Healthcare CIO - August 18, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal Second Week of August 2016
Running an organic farm means that you have to manage animals and plants in concert with the trials and tribulations nature throws in your path. You must become an expert on predator/prey, disease/cure, and seasonal variation. How do you deal with wet/dry, hot/cold, light/dark, insects/rodents, planting/harvesting rhythms etc.For example we know that flea beetles, which eat eggplant leaves die in July. Thus we raise eggplant seedlings indoors and plant them in July.We know what tomato hornworm damage looks like so we can rapidly find the hot dog sized caterpillars and feed them to the chickens.This week ’...
Source: Life as a Healthcare CIO - August 11, 2016 Category: Information Technology Source Type: blogs
A Visit to Oscar Health
Today I ’m in New York City visitingOscar Health, on my continuing quest to determine how best to integrate digital platforms, patient-family engagement, and care coordination in preparation for MACRA/MIPS and the transformation from fee for service to alternative payment models.At the moment, there is no single magic bullet, but there are early innovations that hold promise.At BIDMC we ’ve thought the best approach to care management is to identify a cohort with a disease, then enroll that cohort in a program which involves tracking progress against guidelines/protocols, deploying telemedicine/visiting nurses, and mea...
Source: Life as a Healthcare CIO - August 11, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - First Week of August 2016
The farm refrigerator is 25 years old and this weekend it finally failed. It had two working temperatures - too hot and too cold. After 25 years of hard work it had to be retired, since spare parts are no longer available. The new refrigerator arrived today and our cold chain is up and running again.Tomatoes and peppers are plentiful - here ’s what one morning’s harvest looks like.All our tomatoes are heirlooms, grown organically. For example, we do slug control on the Cherokee Purples by placing bowls of beer in the bed to attract pests and keep them away from the tomatoes. The ...
Source: Life as a Healthcare CIO - August 4, 2016 Category: Information Technology Source Type: blogs
My Guiding Principles
As I ’ve aged and matured my approach to life, career, and family, I’ve evolved my rubric for organizing each day. Here ’s what I’ve used for 2016*Minimize lost timeAvoid commuting delays as much as possible - leave no later than 6:00am in the morning and return either before 3pm or after 7pm. I generally go in early, return early, care for animals, then work in the evening. I work in Boston Tuesday/Thursday, in our suburban Metrowest office Monday/Wednesday and wherever the most urgent projects are happening on Friday.Limit airline travel to impactful events - I have numerous federal/re...
Source: Life as a Healthcare CIO - August 3, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Fifth Week of July 2016
Have you ever heard the expression, “Sweating like a pig” when someone is sweating profusely? < br / > < br / > It ’s a particularly strange statement since pigs don’t sweat much. & nbsp; They have sweat glands but they are not effective, so pigs wallow in mud to keep cool. < br / > < br / > This week in Massachusetts every day has been in the mid 90 ’s with heat indexes about 100F. & nbsp; It ’s been miserable. < br / > < br / > Hazel Marie, our 200 pound pig, has never liked getting wet. & nbsp; Before we adopted her, she lived indoors and never experienced the hot of Summer of the cold of Winter. < br / > < ...
Source: Life as a Healthcare CIO - July 28, 2016 Category: Information Technology Source Type: blogs
The Rise of Telemedicine
As reimbursement evolves from fee for service to alternative payment models, incentives will shift from treating sickness to keeping the population healthy. & nbsp; New investments will be made in technologies that reach into the home and enhance care team communication. & nbsp; & nbsp; 2016 saw an acceleration of telemedicine/telehealth. & nbsp; 2017 will see exponential growth. < br / > < br / > Telemedicine is hard to define. & nbsp; It could be real time video teleconferencing between clinicians (a consult), between a patient and clincian (a visit), or group to group & nbsp;(tumor board discussion). & nbsp; & nbsp;It c...
Source: Life as a Healthcare CIO - July 27, 2016 Category: Information Technology Source Type: blogs
