Unity Farm Journal - Fourth Week of July 2016
“Guineas for sale” < br / > < br / > Our Guinea fowl have been especially productive, so we ’ve sent this message to all the Massachusetts farm mailing lists and posted signs at all the farmstands < br / > < br / > " Guinea Fowl Keets for Sale - 40 available now (born 7/6/16) < br / > Sturdy vigorous baby keets, no stressful shipping involved. Locally bred hatch in many colors from healthy free range birds on a certified organic farm in Sherborn, MA < br / > Contact Us at < a href= " http://www.unityfarmstore.com/contact.html " > http://www.unityfarmstore.com/contact.html < /a > & nbsp;Unity & nbsp;Farm LLC & nbsp;($...
Source: Life as a Healthcare CIO - July 21, 2016 Category: Information Technology Source Type: blogs
Care Coordination Innovation
Would you buy an iPhone if the only apps that ran on it were written by Apple? Maybe, but the functionality would not be very diverse.The same can be said of EHRs. Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data. However, it is impossible for any single vendor to provide all the innovation required by the marketplace to support new models of care I’m a strong believer in the concept of third party modules that layer on top of traditional EHRs in the same way that apps run in the iPhone ecosystem.There are 3...
Source: Life as a Healthcare CIO - July 20, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Third Week of July 2016
It’s the peak of summer with 90 degree temperatures and humidity that pushes the heat index to 100F. We’re also in a drought, so we’ve had to aggressively water the orchard, berries and hoop house. When we built all our agricultural areas we installed drip irrigation or microsprinklers as appropriate for the type of plant. Around the farm we have 64 irrigation zones.The cucumbers, peppers, blueberries, and basil are all ready to harvest and we’ll be bringing them to the Tilly and Salvy’s farmstand this weekend. Our blueberries are divided into 3 separate zones ...
Source: Life as a Healthcare CIO - July 14, 2016 Category: Information Technology Source Type: blogs
Do We Need More or Less Healthcare IT Regulation and Legislation?
Just as I clarified last week in my post about Certification, the answer to the question “do we need more or less healthcare IT regulation and legislation” is that we need the right amount of the right regulations/legislation.Sometimes when clinicians prescribe medication, although it does therapeutic good, it creates side effects which need to be addressed by changing a dose or by adding additional medications.Such is the case with HITECH. It was generally good medicine, but now that we’ve seen the side effects on workflow, clinician burden, and efficiency, there needs to be a dose adjustment.I was recently a...
Source: Life as a Healthcare CIO - July 13, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Second Week of July 2016
As we scale up production of fruits, vegetables, honey, mushrooms, and compost, the key to our success is automation. It’s challenging for two people (my wife and I) to run 15 acres of organic agriculture and support 150 animals part time using only handtools and muscles. Last year, we produced 50 pounds of honey. This year we’ll produce 1200 poundsLast year, we did not sell compost. This year, we’ll bag up 10,000 poundsWe’ve added automation slowly, only in resposne to market demand for our products. For honey extraction, we’ve used a hand cranked centrifuge, which is grea...
Source: Life as a Healthcare CIO - July 7, 2016 Category: Information Technology Source Type: blogs
An Alternative Proposal for Certification
Some have suggested that my comments over the past few months about the Meaningful Use program, MACRA/MIPS, and Certification imply that we should just give up - throw out the baby with the bath water.That’s not what I’ve written.Here’s a clarification.I believe MACRA/MIPS is the right trajectory - create a set of desirable policy outcomes, then enable clinicians to choose technology, quality measures, and process improvements that are relevant to their practice.Although the current MACRA formula is overly complex, it’s the right idea and I’m confident that CMS will revise the notice of proposed rulemaking approp...
Source: Life as a Healthcare CIO - July 6, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - First Week of July 2016
When running a farm you sometimes feel like MacGyver - given a few 2x4s, a piece of hardware cloth, and a box of bags, create a compost bagging machine. Every year, we produce about 10,000 pounds of organic compost from alpaca manure (a 16:1 carbon to nitrogen ratio) and timothy hay (a 45:1 carbon to nitrogen ratio), resulting in a perfect blend of Unity Farm “Llama beans” which has a 25:1 carbon to nitrogen ratio. Alpaca compost has been described as “gardener’s gold” because of its perfect balance of nutrients. One cubic foot weighs 33 pounds, so we can produce 300 bags for sale each year. &...
Source: Life as a Healthcare CIO - June 30, 2016 Category: Information Technology Source Type: blogs
An EHR implementation of The Checklist Manifesto
Boston Physician Atul Gawande wrote The Checklist Manifesto in 2009 stressing that medicine should adopt “pilot’s checklists” to ensure that operating room teams are “ready for takeoff” before a scapel is ever opened.BIDMC implemented The Checklist Manifesto ideas in software in 2010.Here’s the “Time Out” done among all OR team members before a case beings - it includes a list of staff participating in the timeout, the agreed upon procedure, the verification of consent, appropriately marked operative site, patient identity verification, and best practices for prophylaxis. We also have procedure...
Source: Life as a Healthcare CIO - June 29, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Fourth Week of June 2016
Unity Farm is now an organic certified producer of vegetables, herbs, mushrooms, nuts, fruits and seedlings! Here’s our official designationAs I mentioned last week, I’m now doing increased documentation - daily logs of compost temperature and comprehensive recordkeeping about mushroom innoculation dates.Yearly inspection for organic certification compliance is just one of our regulatoryequirements. At the moment we also have*Commercial kitchen designation with yearly health department inspection (including refrigeration facility review)Massachusetts 61A working farming designation with specific doc...
Source: Life as a Healthcare CIO - June 23, 2016 Category: Information Technology Source Type: blogs
Why Apple HealthKit in iOS 10 Makes View/Download/Transmit Real
Meaningful Use Stage 2 has a requirement that I’ve always considered to be the “cart before the horse” - patients must be able to View/Download/Transmit their data. Viewing is great - we’ve done that at BIDMC since 1999 for all patients and all data. Download makes little sense since at the moment there is nothing a patient can do with a download. Of the 2 million patients at BIDMC, not one has ever requested a download. Transmit makes even less sense since there is no place to transmit the data to.All of this will change with Apple iOS 10. What has Apple done? &...
Source: Life as a Healthcare CIO - June 22, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Third Week of June 2016
The baby geese are now old enough to free range with their parents, so they are wandering through the forest and barnyard from 7am to 7pm, occassionally stopping for a pool party in the pond. We believe we have two male and one female young geese, bringing our total to 3 males and 4 females. Will be interesting to watch their dynamics and relationships as they age. Every week on the farm has some unique learning experience. What should you do when you find a baby blue jay on the ground, either fallen from the nest or having failed its initial flight? The general rule of thumb is to do...
Source: Life as a Healthcare CIO - June 16, 2016 Category: Information Technology Source Type: blogs
Why I Disagree with the Snake Oil Analogy
Earlier this week, the American Medical Association CEO called digital healthcare products modern-day "snake oil"As a provider and a technologist, I think we need a deeper dive to understand the issues, avoiding the kind of hyperbole that’s so common in politics today.Paul B. Batalden, MD, Senior Fellow, Institute for Healthcare Improvement (IHI), once said “Every system is perfectly designed to get the results it gets”.Let’s take a brief look at the history of national healthcare IT efforts from 2004-2016 to understand how we’ve achieved exactly the results we designed.In 2004, National Coordinator David Brailer...
Source: Life as a Healthcare CIO - June 14, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - Second Week of June 2016
This week we completed our organic inspection, which was very much like a Joint Commission visit. The “commissioners” arrived for a suprise inspection on a Monday morning. They covered hundreds of criteria from water purity to seed use to composting techniques. They reviewed documentation and checked every package of supplies for appropriate OMRI compliance. Recordkeeping in organic farming is key such as daily compost temperature measurements that ensure a pathogen free product. I learned an immense amount during the inspection and will be enhancing a number of processes and con...
Source: Life as a Healthcare CIO - June 9, 2016 Category: Information Technology Source Type: blogs
A Time of Uncertainty
The upcoming presidential election has everyone spooked - what if Donald Trump is actually elected? What will the transition of administrations, regardless of who is elected mean to healthcare and existing healthcare IT regulations? Will our strategic plans and priorities need to change?I’ve spoken to many people in government, industry and academia over the past month about the rapid pace of change stakeholders are feeling right now. Here are a few of their observations:1. In the next year or two there will continue to be consolidation in the healthcare IT industry. &n...
Source: Life as a Healthcare CIO - June 8, 2016 Category: Information Technology Source Type: blogs
Unity Farm Journal - First Week of June 2016
My daughter's post wedding bliss was followed by the newlyweds move out of Tufts (Medford, MA) and a move into a new apartment in Brookline, MA. My son in law will be attending graduate school in the Longwood Medical Area. Over the past few years, I’ve worked on many moves - parental moves, our own moves, and now my daughter’s move. At this point, everyone in the family is ideally situated for the next phase of life. I can only hope we’ll have a decade without any more moves!We’ve had a very unusual May with high heat and high humidity. That caused the lettuce in the hoop house to ...
Source: Life as a Healthcare CIO - June 2, 2016 Category: Information Technology Source Type: blogs
