Wearable Computing at BIDMC
Over the past few months, Beth Israel Deaconess has been exploring the use of wearable computing.In the Emergency Department we’ve been evaluating an early unit of Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor.We have been able to access our internal web-based ED Dashboard on Glass, in a secure manner that ensures all data stays within the BIDMC firewall. Clinicians can now speak with the patient, examine them, and perform procedures while simultaneously seeing data from the ED Dashboard in their field of view.Beyond the techn...
Source: Life as a Healthcare CIO - March 12, 2014 Category: Technology Consultants Source Type: blogs
A Primer on Meaningful Use and HISPs
The Massachusetts State government offers low cost HIE services including Direct transport to all the stakeholders of the Commonwealth. Recently. Micky Tripathi wrote this FAQ which is so good that I wanted to share it on my blog. Feel free to use it with your stakeholders.1. What is a HISP?A Health Information Services Provider (HISP) is an organization that manages security and transport for health information exchange among health care entities or individuals using the Direct standard for transport. There is no specific legal designation for a HISP, nor are HISPs specifically regulated by Meani...
Source: Life as a Healthcare CIO - March 6, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - The Ducks
As the weather begins to improve (we’ve even had an afternoon above freezing - wahoo!), the ducks are beginning to wander farther from their duck house. This week, they discovered the rain cistern that collects runoff from our farmhouse roof.For hours, they’ll bathe, preen, and drink their fill of the circulating rainwater. They’re very social and tend to travel in groups. They’re calm and have learned to recognize us as helpful rather than threatening.We have 10 ducks at the moment -2 Chocolate Indian Runner ducks2 Fawn Indian Runner ducks2 Welsh Harlequin ducks2 Swedish Blue ducks2 Rouen ducksT...
Source: Life as a Healthcare CIO - March 6, 2014 Category: Technology Consultants Source Type: blogs
ACO Systemness and Integration
As Accountable Care Organizations take on risk contracts which align incentives to create continuous wellness rather than treat episodic sickness, there is a drive to create “systemness” by moving from acquisitions of practices and hospitals to integration. There are many ways to accomplish this such as moving to a single EHR with a single database for all sites, by enhancing interoperability of existing software, and by building care management databases that incorporate data from every care location. Developing a strategy requires a multi-factorial analysis - requirements, cost, competing priorities, reg...
Source: Life as a Healthcare CIO - March 5, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Managing wood
Last weekend I drove to West Bridgewater, MA and picked up a 500 pound SuperSplitter (J Model 6.5hp Honda engine). It’s now installed in the wood processing area with 10 cords of wood to be split on one side and 10 cords of self-built storage racks on the other.Here’s our wood management plan by tree species:Eastern Red Cedar - we never cut cedar, which is a slow growing resinous tree that lives for 800 years. We have hundreds of cedars on the farm, some of which were planted at the edges of pastures in the 1800’s. Cedar waxwings eat the berries and spread the seeds. As our Revolution...
Source: Life as a Healthcare CIO - February 27, 2014 Category: Technology Consultants Source Type: blogs
Social, Mobile, Analytics, and Cloud
On Monday at HIMSS, I signed my new book, Life as a Heathcare CIO for 300 folks at HIMSS. During the rest of the day I met with numerous companies, leaders, and fellow IT professionals. The theme I heard frequently was the need for care management/population health applications based on data acquisition, normalization, mining, and workflow. Common characteristics of such applications included social networking features to gather data from patients/families/providers, a mobile component, a predictive analytics component, and cloud hosting.I had no idea that the major consulting companies and analysts&nb...
Source: Life as a Healthcare CIO - February 26, 2014 Category: Technology Consultants Source Type: blogs
The Voluntary 2015 Edition Electronic Health Record Certification Criteria
There's nothing like a crisp New England winter evening, a roaring fire, a cup of cider, and a 242 page Notice of Proposed Rulemaking to fill your Friday night.I've summarized the preamble and all 50 criteria to save you time as you consider the proposals during the 60 day comment period. Note that no vendor needs to implement 2015 criteria and no provider needs to adopt 2015 certified software, hence the term voluntary. In many ways, this document is meant to signal what might be included in the 2017 edition that supports Meaningful Use Stage 3.Roughly 60% of the 2014 Edition EHR certification criteria ...
Source: Life as a Healthcare CIO - February 22, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Planning for Spring
In the past 18 days, we've had 9 snow days. The small silver nub in the center of this picture is a yardstick placed in the snow on the patio. The squirrels can walk up to the bird feeder. It's time to have a heart to heart with the groundhog who suggested 6 more weeks of this. For the first time, this week, I cannot split wood because the logs are buried too deep. Mulch and manure are similarly inaccessible. The snow banks are as high as the roof of the hoop house, so watering vegetables took an hour of concerted shoveling to find the door. I carved a moat around ...
Source: Life as a Healthcare CIO - February 20, 2014 Category: Technology Consultants Source Type: blogs
The February HIT Standards Committee
focused on development of the 2014 standards workplan, refinements to meaningful use stage 3 attestation/certification processes, and recommendations for standards to capture patient generated healthcare data.Jon Perlin led the workplan discussion. Over the next 30-60 days, ONC will reflect on short term and long term policy goals, which will guide Federal Advisory Committee plan development. We'll use the new strategic guidance to revise the structure of our workgroups/task forces/power teams with a special emphasis on the need for the Policy and Standards Committees to coordinate their work. Standards Commi...
Source: Life as a Healthcare CIO - February 18, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Managing the Woodland, Manure, and Bees in Winter
I've written about our winter preparations and keeping the animals healthy in the 6 months of sub-freezing weather we have in New England. It's been a particularly cold winter in Massachusetts. It's currently 2 degrees F and we're expecting another foot of snow.As the snow gets deeper, the icicles get longer, and all unheated water becomes a solid chunk of ice, how do we manage our weekly work routine on the farm?Our 15 acres of woodland require constant maintenance - bucking fallen trees, removing broken branches, repairing trails/bridges, splitting wood, and making chip piles.The new Terex PT30 compact track...
Source: Life as a Healthcare CIO - February 13, 2014 Category: Technology Consultants Source Type: blogs
Time for a New Optimism
Readers of my blog know that over the past year, I've written several posts warning about the burden of 2014 certification, the timing overlap of numerous federal programs including ICD10, and my observations that IT professionals/providers are at the breaking point.However, I have reasons to be optimistic and it's not just the approach of Spring.1. There is a new national coordinator who is a great listenerI have every expectation that Karen DeSalvo will gather input from stakeholders and adjust the trajectory of national HIT policy within the limits of regulatory process constraints. She understands the...
Source: Life as a Healthcare CIO - February 12, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - 'B' School Begins
As I mentioned last week, my wife and I have enrolled in an evening Bee school to formalize the beekeeping knowledge that to date we've picked up from books and our early experiences with 8 hives at Unity Farm.It's been a hard winter in Massachusetts. Over the past 24 hours, Unity Farm has had over a foot of wet, heavy snow. We're waiting for a warm day to open the hives and check on the bees. Although we've provided supplemental food and kept the hives dry, there is a high overwinter bee mortality in New England, with about 80% of colonies dying. The bee school will provide us with the best practices ...
Source: Life as a Healthcare CIO - February 6, 2014 Category: Technology Consultants Source Type: blogs
Standards for Patient Generated Healthcare Data
At last week's Meaningful Use Workgroup meeting, Leslie Kelly Hall and I reviewed the HIT Standards Committee recommendations for patient generated healthcare data from online applications and devices.We offered guiding principles for Meaningful Use Stage 3 in general. Meaningful Use should avoid "certification only" items since requiring engineering in products to support untested workflows with immature standards is unlikely to accelerate progress. We should only apply standards/certification to those processes where they are needed and useful.For patient generated data sent from interfaced applications, CC...
Source: Life as a Healthcare CIO - February 5, 2014 Category: Technology Consultants Source Type: blogs
The Meaningful Use Workgroup Recommendations
Discussion questions:a. Will tracking every intervention and user response, a technically challenging activity, substantially impact healthcare quality/safety, research, or efficiency?b. Are standards sufficiently well described/mature to author and exchange externally authored rules? c. Must we require that all rules be transmitted or might we allow options such as decision support services in which rules reside in external modules and only questions/answers are exchanged?2. Advance DirectivesCEHRT has the functionality to store the document in the record and/or include more information about the d...
Source: Life as a Healthcare CIO - February 4, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Automation Arrives
Over the past few months, I've asked a dozen farmers what automation is best for Unity Farm's 15 acres of woodland management, manure movement, trail maintenance, food storage, and orchard harvesting. I received thirteen different answers ranging from:Buy John Deere, Kubota is underpoweredBuy Kubota, John Deere is mostly outsourcedBuy from your closest dealer, service really mattersDon't worry about the dealer, do the service yourselfBuy Agricultural tires, they're absolutely necessaryBuy Industrial tires, since Agricultural tires will wreck your propertyBuy a skidsteer/compact track loader for work in mud/sno...
Source: Life as a Healthcare CIO - January 30, 2014 Category: Technology Consultants Source Type: blogs
