Kindling FHIR
Today, at the HL7 Policy Conference, Chuck Jaffe announced The Argonaut Project, an effort to accelerate Fast Health Interoperability Resources (FHIR) in response to the 2013 JASON report , A Robust Health Data Infrastructure, the 2014 JASON report, Data for Individual Health, and the JASON Task Force recommendations.In a vendor neutral approach, Cerner, Epic, Meditech, Athena, McKesson, The Advisory Board and several provider organizations agreed to provide acceleration funding and political will to ensure that HL7 implementation guides which enhance query/response interoperability are available by May 2015.Two FHIR profi...
Source: Life as a Healthcare CIO - December 4, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Thanksgiving 2014
As a vegan farmer in a vegetarian household, I’m always asked some thoughtful Thanksgiving questions.“How do you serve Guinea Fowl?”This is a very challenging question to answer because there is not much literature on the subject. We serve all our 100 animals on Thanksgiving.Two major issues when serving any guest - where do you serve them and what do they want to be served?Should we have an adult table, a kids table, and a guinea fowl table, since the birds tend to be noisy and messy?To answer that question, I offered the poultry a choice of tables, chairs, walls, and logs. As you can see below, t...
Source: Life as a Healthcare CIO - November 27, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Third Week of November 2014
The polar vortex has arrived at Unity Farm and it’s 20F. All standing water has frozen and all outdoor plants have gone dormant. The ducks are confused by their frozen pond but the Great Pyrenees and Alpacas are loving the cooler temperatures which approximate their native mountain environments.As I’ve written about in previous years, preparing for winter on a farm takes a lot of planning. All drinking water is now in heated buckets. Wall mounted heating panels in the coops keep the birds from freezing at night. Perennial beds are covered with salt marsh hay to insulate th...
Source: Life as a Healthcare CIO - November 20, 2014 Category: Technology Consultants Source Type: blogs
The November 2014 HIT Standards Committee
Discussion . When the workgroups were reorganized there was concern about siloing - how do we avoid multiple duplicative work streams in the various workgroups. Steve’s answer is to draw members from each workgroup into an ad hoc task force when multi-disciplinary problems need to be solved. Thus, going forward, we’ll have some projects that are driven by workgroups and others addressed via ad hoc task forces of experts.A good meeting. We all look forward to the upcoming 2015 meetings in which we’ll review ONC’s 10 year interoperability roadmap and the next Notice of Proposed Rulemaking f...
Source: Life as a Healthcare CIO - November 19, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal Second Week of November 2014
The mood at Unity Farm has been somber this week with the death of my father-in-law on Sunday. He was a significant part of seasonal farm activities and was a kind of third parent to my daughter. His death from pancreatic cancer was so rapid that we’re all stuck in the first stage of grieving - denial that it happened so fast.We find ourselves still calling for him to come to dinner, and expecting him to be sitting in his Morris chair as we gather around the hearth in the evening. He will be missed.The duties of farming - seasonal preparation, animal care, and the harvest do no wait for anyone,...
Source: Life as a Healthcare CIO - November 14, 2014 Category: Technology Consultants Source Type: blogs
Becoming the Oldest Living Generation
My father in law died yesterday. His final days were surrounded by family, without pain, and guided by his wishes. He spent 1 day in the ICU, 1 day in a hospital ward, and 1 day in hospice. The journey from eating dinner with the family to death was 1 week. His neuroendocrine pancreatic tumor was highly aggressive, and caused rapid weight loss, muscle wasting, and the inability to swallow without aspirating. His path from life to death was just as I would want for my own - basic hydration, antibiotics for reversible infections, and a comfortable/caring environment with those closest...
Source: Life as a Healthcare CIO - November 10, 2014 Category: Technology Consultants Source Type: blogs
Dispatch from Europe
I’ve been on the road for the past few days, describing the importance of patient and family engagement using mobile applications to healthcare leaders in Europe. The dialog has been bidirectional. I learned a great deal about the technology and policy challenges in each country. Patients, payers, and providers are struggling with issues such as usability, security, and supportability. My schedule has required several time zone changes - a keynote in Seattle on Saturday, a flight to London on Sunday for meetings with NHS leaders on Monday and a keynote in Birmingham on Tuesday. In my dis...
Source: Life as a Healthcare CIO - November 6, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - First Week of November 2014
When you’re a farmer, you’re often faced with the life, death, and sickness of those living things who depend on you.Recently, my father in law was diagnosed with a Stage IV Neuroendocrine Tumor on the head of the pancreas. Ironically, it’s the same disease that Steve Jobs experienced. Chemotherapy began this week and we’re hopeful that shrinking the tumor will relieve some of his symptoms. Cure is unlikely and many difficult decisions await us.With Stage IV cancer, surgery is not an option.If we do nothing, the highly aggressive tumor will cause rapid decline - weight loss, weakness, and suscep...
Source: Life as a Healthcare CIO - November 5, 2014 Category: Technology Consultants Source Type: blogs
New CMS rule allows flexibility in certified EHR technology for 2014
Today is my one day of Summer vacation, enabled by the large number of people taking a long labor day weekend.Some things are worth interrupting your vacation.This afternoon, CMS published he long awaited final rule on Meaningful Use flexibility.Here’s my interpretation.Many CIOs tell me that they will be ready for transition of care and patient view/download/transmit for the full year October 1, 2014-September 30, 2015. However, the ecosystem (trading partners, patient awareness, policy) is not ready for the period July 1, 2014-September 30, 2014. Thus, the ONC final rule is a welcome relief.I do have one ...
Source: Life as a Healthcare CIO - August 30, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - 4th week of August 2014
Over the past week, the combination of rain and cool Fall-like temperatures caused our 165 shitake logs to fruit, resulting in over 50 pounds of fresh mushrooms. We inoculated 5 tons of oak logs last August and throughout the year have had a few pounds to deliver to local farm stands. We really did not know if our work would be successful, since this is our first effort at growing mushrooms to commercial scale. We’re guided by this excellent research paper which illustrates how a family can create a 500 log Shitake operation yielding $5000-$10000 in farm income per year.Now that we know that the comb...
Source: Life as a Healthcare CIO - August 21, 2014 Category: Technology Consultants Source Type: blogs
The August HIT Standards Committee
focused on the work ahead to accelerate interoperability. It’s no longer about Meaningful Use, it’s about Meaningful healthcare information exchange. I offered my opinion about the work ahead. ONC is in the middle of regulation writing for Meaningful Use Stage 3, so the standards work of the next 10 weeks is not going to be incorporated into the NPRM. Regulation is not the only way that health IT standards are defined, selected, or adopted by industry.Learning from Stage 2, it’s critical that we decouple regulation writing from creating test procedures and scripts for certification. I’m co...
Source: Life as a Healthcare CIO - August 20, 2014 Category: Technology Consultants Source Type: blogs
The End of a Busy Week
Luckily, all my ducks are in a row (Source: Life as a Healthcare CIO)
Source: Life as a Healthcare CIO - August 15, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Third Week of August 2014
As a doctor for over 20 years, I’ve learned how to treat critical healthcare issues. As a father, son, and husband I’ve learned how to support my own family through injury, sickness, and death.As a farmer responsible for over 100 animals, life and death are part of the daily experience.Sunny, our baby alpaca, is now doing extremely well. She did not successfully receive the immunoglobulin transfer that happens between mother and baby with consumption of colostrum, the first mother’s milk. Her tests revealed she had an incomplete immune system and was unlikely to survive an infection. She w...
Source: Life as a Healthcare CIO - August 14, 2014 Category: Technology Consultants Source Type: blogs
The Meaningful Use Stage 2 Finish Line
Hospitals across the country have until September 30 to complete their 2014 reporting period for Meaningful Use Stage 2.Recently Ashish Jha and Julia Adler-Milstein published important articles in Health Affairs about the current state of EHRs and Health Information Exchange . What can we learn about the status of Meaningful Use Stage 2 across the country?The trajectory is very positive but the position is less than perfect. Hospitals are struggling with patient view/download/transmit and provider/provider transition of care summaries. Eligible professionals, often with limited resources, ar...
Source: Life as a Healthcare CIO - August 13, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - First Week of August 2014
We continue to be on cria watch, as our last pregnant alpaca, Mint, waddles around the paddock. The alpaca gestation period is 11.5 months and Mint is just about there.Just as 17 keets (baby guineas) appeared from the forest last week, 10 appeared this week. One of the teenage keets that was raised by ducks disappeared into the forest and likely was eaten by a coyote. That means our current guinea inventory is27 adults3 keets born June 9 - will be released to the barnyard on August 179 keets born on July 4 - will be released to the barnyard on September 1217 keets born on July 27 will be released...
Source: Life as a Healthcare CIO - August 7, 2014 Category: Technology Consultants Source Type: blogs
