Unity Farm Journal - 4th week of June 2014
Last weekend, we had two days of clear, warm weather, perfect for harvesting vegetables, inoculating mushrooms, and caring for bees.We received 40 pounds of mushroom spawn from our supplier, Field and Forest, and we created two new mushroom areas - 4 raised beds of compost with Agaricus (almond mushroom) and 12 new stacks of logs with Oysters. The Golden Oysters are beginning to fruit in the warm humidity of summer afternoons.Eating on the farm can be as simple as taking a basket to the hoop house and gathering a potpourri of delectable vegetables. Sunday’s brunch was a bowl of fresh strawberrie...
Source: Life as a Healthcare CIO - June 26, 2014 Category: Technology Consultants Source Type: blogs
Interoperability in Real Life
On Monday afternoon my wife was speaking with my 82 year old father-in-law, when he began speaking in word salad - not slurring his words, but clearly speaking words that made no sense. He had no numbness or weakness, no confusion, and no change in consciousness. After 5 minutes all symptoms resolved.My wife called me and after hearing the history, I knew he was having a transient ischemic attack (TIA). Given that he was stable, I recommended that we coordinate an immediate hospitalization at a site suggested by his primary care physician (PCP) rather than take an ambulance to a random nearby location. ...
Source: Life as a Healthcare CIO - June 25, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Third Week of June 2014
With evenings lit by the amber hues of the June Honey Moon, we diligently worked on bees, hives, and honey over Father’s Day weekend.At the beginning of the weekend, we had 11 hives, but with the transfer of queen cells to prevent swarming we ended the weekend with 12 hives.One by one we opened each hive, checked for signs of health issues, looked for queens, checked eggs/larva, inventoried food stores, and documented wax building progress. Frame by frame we reviewed the status of 100,000 bees. Here’s our reportHive 1First honey super (extra food stores) is full and some is cappedStarting to build o...
Source: Life as a Healthcare CIO - June 19, 2014 Category: Technology Consultants Source Type: blogs
The June HIT Standards Committee
focused on an update and evaluation of the standards and interoperability framework initiatives, consistent with the overall theme of ONC’s recent reorganization and strategic plan to focus on fewer goals with a greater depth. Steve Posnack, who now leads the ONC Office of Standards and Technology, introduced the topic. Mera Choi and John Feikema provided an overall update. Evelyn Gallego, Jonathan Coleman, and Marc Hadley described their projects.It was truly an amazing discussion. The energy in the room was palpable.Common themes included*Embrace FHIR, JSON, REST and OAuth*Avoid...
Source: Life as a Healthcare CIO - June 17, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - Second Week of June 2014
My wife and I did not think it was possible for a duck to hatch guinea fowl, but this week it happened.Guinea fowl are horrible parents.They lay their eggs in piles throughout the forest and then abandon them. Even if a “designated layer” sits on the communal egg pile, the young often get wet and chilled after hatching and do not make it back to the coop.A few weeks ago, the guineas decided to lay a few eggs in the duck house. Five of the ducks instantly began sitting on the eggs in shifts, keep them warm and protected.Our sense was that dry guineas offer a very different humidity environment than c...
Source: Life as a Healthcare CIO - June 12, 2014 Category: Technology Consultants Source Type: blogs
The ONC 10 Year Vision
On June 5th 2014, ONC released “Connecting Health and Care for the Nation: a 10-Year Vision to Achieve an Interoperable Health IT Infrastructure" The plan is divided in 3 year goals, 6 year goals, and 10 year goals. Five specific tactics support the strategies.Below is a summary of the report and a few comments from my Massachusetts experience that support the reasonableness of the ONC goals. Based on the trajectory of current technology and policy, I’m confident we can achieve these milestones. One caveat - since Meaningful Use Stage 3 takes effect in 2017, three years from now, we will need ...
Source: Life as a Healthcare CIO - June 11, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - First Week of June 2014
As Spring begins to transform into Summer, everything on the farm is a sea of green. As Paul Simon wrote in 1973 KodachromeThey give us those nice bright colorsThey give us the greens of summersMakes you think all the world'sa sunny dayAll of the guinea fowl are in crazed Summer mating mode, with males chasing females all over the property and communal nests appearing in the forest, with clusters of 30-40 eggs. On some nights a “designated layer” sits on the nest and sometimes does not survive the prowling foxes, coyotes and fisher cats. We lost one guinea this week, so we’re down to 27.I’v...
Source: Life as a Healthcare CIO - June 5, 2014 Category: Technology Consultants Source Type: blogs
The ONC Reorganization
Many people have asked me to explain the recent reorganization at ONC, reducing 17 different offices to 10:Office of Care Transformation: Kelly CroninOffice of the Chief Privacy Officer: Joy PrittsOffice of the Chief Operating Officer: Lisa LewisOffice of the Chief Scientist: Doug Fridsma, MD, PhDOffice of Clinical Quality and Safety: Judy Murphy, RNOffice of Planning, Evaluation, and Analysis: Seth PazinskiOffice of Policy: Jodi DanielOffice of Programs: Kim LynchOffice of Public Affairs and Communications: Nora SuperOffice of Standards and Technology: Steve Po...
Source: Life as a Healthcare CIO - June 4, 2014 Category: Technology Consultants Source Type: blogs
Apple Enters the Healthcare Software Ecosystem
Here's a guest post by Dr. Henry Feldman from BIDMC's Division of Clinical Informatics:I am writing this from the Apple Worldwide Developer Conference (WWDC) today here in San Francisco, where I got to substitute for John Halamka at the Keynote (now I keep having urges to raise Alpacas); John missed the most amazing seats [front row center!]. There were many, many, many (I can not recall a set of software announcements of this scale from Apple) new technologies that were announced, demoed and discussed, but I will limit this entry to a few technologies that have implications for healthcare.If you remember the state of digi...
Source: Life as a Healthcare CIO - June 3, 2014 Category: Technology Consultants Source Type: blogs
Unity Farm Journal - The 5th Week of May 2014
The Memorial Day weekend included shearing day on the farm. Every year in May, we trim 15 pounds of fiber from each alpaca, removing a body size “down jacket” just in time for Summer. The animals are transformed from teddy bears to Dr. Seuss animals. We gently halter the animals and reassure them with ear and chin massages. Then we lead them to a foam pad and use a soft rope to restrain their legs so that they cannot move while the sharp clippers are shaving their fiber. We also use the opportunity to trim their teeth and nails. In two hours, the work was done and the newly shear...
Source: Life as a Healthcare CIO - May 29, 2014 Category: Technology Consultants Source Type: blogs
Early reaction to the Electronic Health Record Incentive NPRM
Last week, I posted the Notice of Proposed Rulemaking from CMS that offers flexibility to Meaningful Use attestation in 2014 .Since then, I’ve received hundreds of emails about it from my fellow CIOs across the country. Here’s a summary:1. To clarify, the NPRM offers flexibility for hospitals to attest to Stage 1 criteria for 2014 from July 1 to September 30. However, it offers no flexibility for 2015 which begins October 1, 2014. This means that hospitals which are struggling with Transition of Care summary exchange, Electronic Medication Admission Records (EMAR), and Patient...
Source: Life as a Healthcare CIO - May 28, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Signs of Spring
Today is the vernal equinox and many people in New England are suffering from seasonal affective disorder after the coldest, snowiest, most relentless winter on record.The 100 animals of Unity Farm are relishing the first 24 hours since November with temperatures above freezing.Around the farm, signs of early spring are upon us. When I walked the Marsh trail this morning I saw skunk cabbage poking through the icy ground. Skunk cabbage is biologically warm and is generally the first plant to leaf out in the wetlands. Our bees are likely to fly today and bring skunk cabbage pollen back to the hives...
Source: Life as a Healthcare CIO - March 20, 2014 Category: Technology Consultants Source Type: blogs
Is Continuous Partial Attention part of Human Evolution?
During my Freshman year in high school, I was asked to write a major project paper. Armed with only a electric typewriter and access to a local library, I decided to write a comprehensive summary of the engineering principles used in Leonardo Da Vinci’s inventions spanning 80 single spaced pages. The only way I could do this was to focus completely on the task for hours at a time, reading, analyzing, writing, typing. There was no internet, no mobile devices, and no personal computer which enabled easy editing.As an undergraduate at Stanford I wrote 3 books by isolating myself from all distractions and ...
Source: Life as a Healthcare CIO - March 19, 2014 Category: Technology Consultants Source Type: blogs
The Meaningful Use Stage 2 Hardship Application
Many people have emailed me about the Meaningful Use Stage 2 Hardship application for hospitals and eligible professionals.The most common question is - if I apply for hardship, what happens to my incentives and penalties? Here is my understanding:Put simply, if you want to get an incentive you have to do MU. For *Medicare* providers once they start their first payment year their yearly clock for incentives keeps ticking regardless of whether they do MU or not. So miss a year = no incentive. The following year would be whatever the next available incentive is scheduled to be, NOT the one that was just mis...
Source: Life as a Healthcare CIO - March 13, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Winter Hive Maintenance
The 2014 winter has been brutal with more single degree days than any winter during my 20 years living in Massachusetts. Our bees are resilient, started from colonies overwintered in New Hampshire last year. Keeping them alive has required careful management and we’ve learned a great deal in our first year as beekeepers.We began the winter with 8 hives, 7 of which were strong and one of which had very few bees.Our hives started as “nucs” 5 frame mini hives purchased from an apiary. We placed the frames in 10 frame deep body boxes last May. After a few months, we added another layer of 10 fr...
Source: Life as a Healthcare CIO - March 13, 2014 Category: Technology Consultants Source Type: blogs
