Management Lessons Learned from A Game of Thrones
A Game of Thrones is the first novel in A Song of Ice and Fire, a series of high fantasy novels by American author George R. R. Martin.I rarely watch television, but for Christmas, my wife bought me Season 1 of Game of Thrones, the HBO series inspired by the novels. Don't worry, this blog post will not contain any spoilers. Watching the characters jockey for power and influence reminded me of my experience navigating organizations over the course of my career. Here are my top lessons learned from the series:1. Doing the right thing does not always workI have strongly believed that the nice guy can ...
Source: Life as a Healthcare CIO - January 29, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Winter Fermentations
It's the dead of winter in New England, with new snow on the ground and temperatures near zero. The animals are clustered together in their barn spaces and heated buckets are keeping their water liquid.There are many indoor tasks to do on the farm during winter - sharpening chain saw chains and other tools, reorganizing the workbench, ordering seeds, planning for Spring planting (we've been tractor shopping), and nurturing all the fermentations begun in the Fall.Our fermentations include 3 kinds of cider, mead, cyser (a mixture of cider and honey), vinegar, sourdough,sauerkraut, and fermented pickles. H...
Source: Life as a Healthcare CIO - January 23, 2014 Category: Technology Consultants Source Type: blogs
Advice to the New National Coordinator
Karen DeSalvo started as the new National Coordinator for Healthcare Information Technology on January 13, 2014. After my brief discussion with her last week, I can already tell she's a good listener, aware of the issues, and is passionate about using healthcare IT as a tool to improve population health. What advice would I give her, given the current state of healthcare IT stakeholders?1. Rethink the Certification Program - With a new National Coordinator, we have an opportunity to redesign certification. As I've written about previously some of the 2014 Certification test procedures have neg...
Source: Life as a Healthcare CIO - January 22, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - The Sounds of Unity Farm
Since moving to the farm in April of 2012, I've posted many pictures of our efforts to create a working farm in Sherborn, Massachusetts. Although it's winter, the farm still bustles with activity. To give you a sense of what I experience every morning as I walk through the barnyard tending to the creatures, I carried an Olympus USB audio recorder with me on a recent morning.On the front of the farmhouse we have a rain chain in lieu of gutters that drains into a cistern to capture water. It was raining during my recording you'll hear my walk from farm house, past the rain chain, to feed the guinea...
Source: Life as a Healthcare CIO - January 16, 2014 Category: Technology Consultants Source Type: blogs
The Roles I Play
As 2014 begins, I marvel at the evolution of the CIO role from 1997 to 2014. Gone are the days when my role was to serve as technical expert, configuring web servers, optimizing data bases, or simplifying code. Gone are the days when product decisio nmaking depended on software architecture expertise to ensure scalability, reliability and security. Gone are the early wins of the "bold moves" like replacing Lotus Notes with Exchange, Novell with NT, Sybase with Microsoft SQL, and client/server with web applications.Here are a few examples of the roles I play today from the past few weeks1. Rethink...
Source: Life as a Healthcare CIO - January 15, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Thinking about Automation
Every year at Unity Farm, I move 10000 pounds of manure, 10000 pounds of logs (18 inch segments), 10000 pounds of wood chips, and thousands of pounds of snow. I've done this to date using a hand cart and wheelbarrow. I turn 52 in a few months and its time for automation.But, what's the ideal device? We have hills, forests, meadows, mud, ice, and grass.A tractor such as the Kubota B3200HSD seems reasonable with industrial R4 tires that provide traction without too much damage to underlying soil. John Deere offers a competitive model of tractor, the 3032E. However, many of the trails a...
Source: Life as a Healthcare CIO - January 9, 2014 Category: Technology Consultants Source Type: blogs
The Next Phase of Healthcare Information Exchange
Today, Massachusetts Governor Deval Patrick will launch the next phase of healthcare information exchange (HIE) in Massachusetts - “Commonwealth Interconnected: Mass HIway Query and Retrieve”In Phase 1 of our state HIE project, we focused on the Meaningful Use Stage 2 Direct protocol, enabling transition of care summaries, public health reporting transactions, and labs to flow over a state operated secure infrastructure.In Phase 2, we solved a much harder and more complex problem - the pulling of records in real time from physician offices and hospitals where patients have opted in to disclose their records to ot...
Source: Life as a Healthcare CIO - January 8, 2014 Category: Technology Consultants Source Type: blogs
Baby, It's Cold Outside
For those who not have experienced Winter Storm Hercules , it's currently -10F at Unity Farm (not wind chill, that's -15F). We have 10 inches of new fallen snow.As I've written about previously, all the animals have protection from wind and water. Wall mounted heaters are protecting them from frostbite. At dawn we gave the alpaca and llama large bowls of alfalfa mixed with molasses. The chickens and guinea fowl ate hot oatmeal mixed with dried cherries. The ducks got a warm duck soup of chopped greens and warm water. The dogs got an extra helping of the...
Source: Life as a Healthcare CIO - January 4, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Making Mead and Cyser
The entire family visited Unity Farm for the holidays. After all the gift giving, merry making, and yuletide time by the fire was over, what should a family do at a farm with apples, honey, fermentation equipment (there's a basic chemistry lab in the cider house), spring water, and microbiology know-how? Make mead of course!Mead was the earliest fermented beverage created by man - evidence of honey and fermentation products begins about 9000 BC. Mead figures prominently in Hindu writings, the work of Aristotle, and the Old English poem Beowulf. There's a new vocabulary to learn when deciding how ...
Source: Life as a Healthcare CIO - January 2, 2014 Category: Technology Consultants Source Type: blogs
The Year That Was 2013
As the year drew to a close, I was interviewed by many trade publications about the key themes that shaped 2013. Here's my own version of the notable events of 2013.1. Meaningful Use changed the EHR landscapeRegardless of your political affiliation, there is little debate that EHR adoption in the US achieved a tipping point in 2013. Here are our Massachusetts statistics from the 2013 Massachusetts Medical Society surveyThe current overall percentage of EHR use is 79% (N=201, CI=5.6) and 82% of those using EHRs have had access to this technology for more than 2 years. Extrapolated to the estimated 18,000...
Source: Life as a Healthcare CIO - January 1, 2014 Category: Technology Consultants Source Type: blogs
Building Unity Farm - A White Christmas on the Farm
It's Christmas at Unity Farm and the temperature outside is 12F. All 100 animals are fed, watered, and their living quarters are cleaned.The orchard and cider house have been put to bed. I racked the last 60 liters of our fermented cider into three 20 liter Spiedel tanks and inoculated two of them with malolactic bacteria (Oenococcus oenii) to soften the acids and round out the flavor. We'll bottle still and sparking cider in the Spring.The hoop house is filled with salad greens, thriving in the balmy temperatures of cold frames and planting blankets. The soil temperature of our 15 raised beds i...
Source: Life as a Healthcare CIO - December 25, 2013 Category: Technology Consultants Source Type: blogs
The December HIT Standards Committee
focused on patient generated data, image sharing, patient matching, and the 2014 work plan, ensuring we select the necessary standards to support Meaningful Use stage 3 policy goals.We began the meeting with a discussion by Leslie Kelly-Hall of patient generated healthcare data - structured and unstructured questionnaires plus patient provided medical history such as medications, allergies, and problems. The key discussion was an evaluation of the standards maturity and the level of adoption of the standards suggested for patient generated data exchange. Recommendations included Direct for data t...
Source: Life as a Healthcare CIO - December 19, 2013 Category: Technology Consultants Source Type: blogs
Become a Mountain
When I was 16 years old I wrote a short collection of poems. The cover page listed a few youthful notions that would become my life long guiding principles:"Be wary of artificial limits and self-compromiseIf the world praises mediocrity, don't seek praiseBe true to yourselfYou make your own destiny"Some of these ideas were written in response to high school teachers who told me that my goals were unachievable - I should not ask "will I" but "can I".Over my career, I've worked with and for many people. Along the way I've encountered many styles - those who lead by intimidation, those who lead by collaboration,...
Source: Life as a Healthcare CIO - December 18, 2013 Category: Technology Consultants Source Type: blogs
Building Unity Farm - Herd Health
One weekend each month, Kathy and I do "care management" and "population health" for the 100 animals of Unity Farm. Here's the workflow:Llamas/AlpacasWe gently halter each animal and reassure them by rubbing their chins and scratching their ears. After a year with us, we've gained their trust. Many of the animals nuzzle and tuck their heads into our necks, as if to say "Dad, do I really have to go to the doctor?". We then lead each one to the floor scale where we weigh them, looking for monthly variation. Do they have an infection or parasitic issue that is causing weight loss? Have ...
Source: Life as a Healthcare CIO - December 12, 2013 Category: Technology Consultants Source Type: blogs
Google Glass Progress Report
Our teams continue to work on Google Glass applications for Emergency Department workflow improvement. Here's a photo of our team at work with a stealthy startup developing healthcare solutions on Google Glass.Issues we've had to address include decision making about thin client web versus thick client functionality, enabling a persistent secure network connection, and ensuring secure data flows through servers.At the moment we are optimizing the user experience and beginning our study design to record patient reactions and clinician experiences.If patients object we will not use Glass for their encounter. Qua...
Source: Life as a Healthcare CIO - December 11, 2013 Category: Technology Consultants Source Type: blogs
