Sunshine Act/Conflict of Interest
As with previous years, it’s time to openly publish my conflict of interests, board memberships, advisory board positions, and government activities so that anyone reading my opinions has full transparency.The federal government has made financial disclosure very easy with the Sunshine Act. The Physician Payments Sunshine Act (Sunshine Act) requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Centers for Medicare & Medicaid Services (CMS) has been charged with...
Source: Life as a Healthcare CIO - August 6, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - 5th Week of July 2014
The great thing about running a farm is that every day is filled with the unexpected.Sunny, our new baby alpaca did not consume her first meal of mother’s milk in time to receive the antibodies that are necessary to keep her healthy. She was not gaining weight. We had only one choice - a transfusion of alpaca plasma containing IgG (about $150). We drove to Tufts Veterinary School and picked up 500cc of plasma. There are two ways to transfuse a baby alpaca - jugular vein IV or peritoneal infusion. Inserting an IV in a baby alpaca is like wrestling an alligator. We chose the ...
Source: Life as a Healthcare CIO - July 31, 2014 Category: Technology Consultants Source Type: blogs
Real Time Big Data Analytics for Clinical Care
Over the summer, I’ve given many lectures about SMAC - social media, mobile, analytics and cloud computing.The most popular analytics topics are business intelligence, big data, and novel data visualizations.Recently, Dr. Chris Longhurst, chief medical information officer at Lucile Packard Children's Hospital, and colleagues wrote an article in the Big Data Issue of Health Affairs, that suggests a very practical approach for enabling real time analytics within an EHR. They call it the Green Button.The Blue Button is for patient view/download/transmit of medical records.The Green Button is for instant access to out...
Source: Life as a Healthcare CIO - July 30, 2014 Category: Technology Consultants Source Type: blogs
There’s More to ePrescribing Standards Than You Think
In followup to my guest post from Dr. Marvin Harper about e-Prescribing gaps, John Klimek, R.Ph., Senior VP, Standards and Information Technology, NCPDP wrote the following helpful guest post:The National Council for Prescription Drug Programs (NCPDP) leaders and members read with interest the guest post from Dr. Marvin Harper, CMIO at Boston Children's Hospital, entitled “Limitations of e-Prescribing Standards.” Dr. Harper’s thoughtful post brings a critical issue to light: the need for increased industry awareness and adoption of the full functionality that already exists in ePrescribing standards – going beyond ...
Source: Life as a Healthcare CIO - July 28, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - 4th week of July 2014
Just as running a winery isn’t all romance, art, and elegance, running a farm is not all romping with your animals, a joyful harvest, and making a profit from the fruits of your labor.Farming is hard work year round, during the hot humid days of summer, the wet days of Spring/Fall and the chill of winter. There’s always maintenance and always unexpected tasks.Some of my farm related posts gloss over the details of day to day operations. This week, I’ll give you a taste of the kinds of things that require attention.Our 1.5 miles of trails, our mushroom operations, and manure management all depend on the Te...
Source: Life as a Healthcare CIO - July 24, 2014 Category: Technology Consultants Source Type: blogs
Patient Generated Data Goes Mainstream
Since 1999, Patientsite, the BIDMC shared record between doctor and patient, has enabled patients to track blood pressure, glucometer readings, activities of daily living, mood, pain etc. but few patients have used those features.Why? Because it requires time and energy to maintain that data.What if data gathering was entirely passive?Today, I own a Withings bathroom scale and Withings Pulse O2 wearable monitor. When I get up each morning, my weight, body mass index, and fat percentage is measured by my scale and wirelessly sent to the Withings cloud where it is routed to my Microsoft HealthV...
Source: Life as a Healthcare CIO - July 23, 2014 Category: Technology Consultants Source Type: blogs
Limitations of e-Prescribing Standards
The following is an important guest post from Dr. Marvin Harper, CMIO at Boston Children's Hospital, identifying a gap in e-prescribing standards:Why am I guest writing a blog post here? As a practicing pediatrician and CMIO at Boston Children’s Hospital I am particularly sensitive to specific limitations of current e-prescribing standards.Being able to write and route prescriptions electronically provides many advantages over the handwritten paper prescription process that inherently uses families as couriers. Nonetheless the current standards for e-prescribing have created a void that permits limitations i...
Source: Life as a Healthcare CIO - July 21, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Third Week of July 2014
Although midsummer is a time of harvest, the focus of the past week has been on the birth of our new baby alpaca, Sunny. Our philosophy at Unity Farm is “living things first” - maintenance, infrastructure, and new projects must wait until all our living things are cared for.Sunny was born at 5pm on July 15 after an 11 1/2 month gestation. She weighed 17 pounds at birth and walked in the first 30 minutes. After an hour she was feeding vigorously and proudly displayed her milk mustache. Her mother is very attentive and the two spend the day playing, resting, and eating. Our travel...
Source: Life as a Healthcare CIO - July 17, 2014 Category: Technology Consultants Source Type: blogs
The July meeting of the HIT Standards Committee
included important discussions of certification for post acute care and behavior health applications, review of data segmentation for privacy, analysis of provider directory standards, an update on the standards/interoperability framework projects, and a first look at the new subcommittee co-chairs of the Standards Committee.We started the meeting with a review of attestation data by Jennifer King. Jacob Reider reminded us not to judge the trajectory of the project based on the those who attested early. The data indicates that the bulk of attestations were completed using just a few vendor products, imp...
Source: Life as a Healthcare CIO - July 16, 2014 Category: Technology Consultants Source Type: blogs
A New Arrival at Unity Farm
Today at 5pm, our first baby alpaca was born at Unity Farm. She's 17 pounds and her name is Sunny. She's eating well and running around the paddock. The herd is caring for her attentively.My only role was caring for mom and ensuring the placenta was delivered intact. Here's a photo of her first steps. (Source: Life as a Healthcare CIO)
Source: Life as a Healthcare CIO - July 16, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Second Week of July 2014
I returned from Japan to find that 9 baby guineas (keets) raised by ducks had hatched. We have one adult white guinea and its genetics seem recessive - of the 100+ keets we’ve hatched there have been no whites. In this batch, we finally got a white. Since our one adult white is sitting on a batch of 40 eggs, it’s possible that more whites are on the way. During the Summer, our guineas build nests and spend the night outside the coop. At the moment we have 21 guineas roosting in the coop, six sitting on nests, four babies in the mini-coop, and nine in the brooder (pictured below)...
Source: Life as a Healthcare CIO - July 10, 2014 Category: Technology Consultants Source Type: blogs
Crafting a Next Generation IT strategy
During my 16 years as CIO, I’ve witnessed the transition from client server to web, from desktops to mobile, and from locally hosted to cloud. As Beth Israel Deaconess merges and acquires more hospitals, more practices and more care management capabilities, what are its strategic IT choices?I will not even mention “best of breed”, because I think the industry has abandoned such a strategy as unworkable in an era when everyone needs access to everything for care coordination, population health, and patient/family engagement.The choices are basically twoa. Single monolithic vendor application for everyone ...
Source: Life as a Healthcare CIO - July 9, 2014 Category: Technology Consultants Source Type: blogs
On Top of Mt. Fuji
July 4 began with a breakfast meeting to discuss cloud computing with Japanese industry leaders. Japanese industry is ready to provide cloud solutions, but there are policy and adoption barriers including privacy protection, service level guarantees, and general distrust of the internet as a transport mechanism for healthcare data. To explore these barriers, I visited the Japanese Medical Association for lunch and had a remarkable discussion while walking in the Rikugien Gardens. I spent the afternoon with policymakers at the Japanese Ministry of Health, Welfare and Labor. We review...
Source: Life as a Healthcare CIO - July 5, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - First week of July 2014
While I’m in Japan, Kathy has her hands full at Unity Farm. I did my best to prepare the farm for my 5 days away including building bee hive supplies, ensuring the health of all the animals, and completing all the monthly maintenance tasks.As I’ve posted before, Guinea fowl are horrible parents. They lay eggs in a communal pile then assign a designated layer to incubate them. When the eggs hatch the young have to find their way to the coop, often through tall wet grass and through predator laden terrain. Most don’t make it. This year, we’re helping them a bit.The ducks hatched 4 gui...
Source: Life as a Healthcare CIO - July 3, 2014 Category: Technology Consultants Source Type: blogs
Dispatch from Tokyo
I’m in Japan today lecturing at the TOPOS Conference. per the request of several colleagues. Think of it as TED in Tokyo. I’ve been asked to discuss the Meaning of Life in an Aging Society without referencing Healthcare IT, which is a real challenge for a CIO.The approach I’ve taken is to explore life through the eyes of those in my family - my father who passed away last March, my mother, my wife and my daughter. I’m reviewing our experiences together and the impact they’ve had on my life, while recounting what is meaningful to them. Here’s the powerpoint I’m using. Tomorrow ...
Source: Life as a Healthcare CIO - July 2, 2014 Category: Technology Consultants Source Type: blogs
