HTM and IT: frenemies or collaborators?

What is a “frenemy”? According to Dictionary.com: “person or group that is friendly toward another because the relationship brings benefits, but harbors feelings of resentment or rivalry”.canstockphoto5722510

Within health care organizations, there is a lot of history between the people who support the medical devices that touch patients and those who support the information systems used by clinicians. It has not always been positive and collaborative. In fact, there are such differences in the culture of each group that they don’t always get along. Maybe they are even “frenemies” in some organizations.

In your hospital, you may know the function as Biomedical Engineering, Biomed, Clinical Engineering or Health Technology Management (HTM) as it is now called as part of elevating the profession within healthcare. Those in the field now refer to themselves as “HTMs”.

AAMI (Association for the Advancement of Medical Instrumentation) is a standards development organization and the professional society for HTMs. AAMI is celebrating its 50th anniversary this year. Its mission is to advance safety in healthcare technology.

Four years ago, I was the first CIO ever to be elected to the AAMI board when AAMI leaders recognized the trend towards HTM and IT convergence and integration. I have provided the IT perspective to the AAMI board as the HTM profession continues to evolve. Continue reading

Are we ready for the business of the day?

“Huddles, not just another meeting;” I wrote that when we started our twice a week IT leadership huddle in April. How true! And as of three weeks ago, we have another leadership huddle experiment in progress – the daily hospital leadership huddle. It is part of our developing lean Daily Management System.

Our Acting CEO and COO for the University of Michigan Hospitals and Health Centers, Tony Denton, runs the daily huddle. As Tony said in his initial communication, “The purpose of the leadership huddle is for senior leaders to have daily awareness of issues that may impede our ability to provide service. The leadership huddle is the “top tier” of a daily management system designed to surface issues and problems, assign leads for pro-active problem-solving efforts, examine trends and track progress. It is a key aspect of developing a more effective Michigan Operating System. If successful, we expect to see continuous improvement in our safety, quality, timeliness and financial results, and enhanced ability to deliver ideal patient and family care experiences through the engagement of our people.”

The value of these leadership huddles was clear the first week. Continue reading

Our collective interoperability journey

If you remember the CHIN (Community Health Information Network) attempts in the 1990s or the next incarnation in the mid-2000s referred to as RHIOs (Regional Health Information Exchange), you know we’ve been on this interoperability journey in health care a very long time. And it’s not over.

Creating sustainable Health Information Exchanges (HIE), not to be confused with a Health Insurance Exchange, is what we are all focused on now. The Office of the National Coordinator for Health IT (ONC) published “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” for public comments earlier this year. There has been progress over the years but we still have a long ways to go.

The ability to easily access and share data with other health care providers in Michigan is critical for UMHS – we are the only provider in the state that serves patients from every county. But HIEs are important for all providers regardless of their reach.  For example, when a patient shows up at an emergency room away from their primary hospital and physician, basic information should be readily available.  This includes a patient’s current problem summary list, allergies, chronic conditions, and medications.  Having this kind of information can make a qualitative difference in their care. And knowing that a certain test or procedure has recently been done along with the results can avoid duplication, saving both time and money.

Yet, unlike other industries where basic information is easily accessible and shared, health care lags far behind. Continue reading

Making the tough decisions

We make all kinds of decisions every day. Some are small yet seem difficult at the time. One I sometimes joke about is ordering off a restaurant menu that has too many good choices. When I finally make my order, I tell the server that I have made my “major life decision” for the night.

Sometimes a group makes a decision after weeks or months of lengthy deliberation: many groups have weighed in, expressed their concerns, asked their questions, refined the plan or recommendation, and only then ultimately provided their support.

And then there are the potentially very impactful decisions that must be made in a matter of minutes with the best information you have available after a very quick weighing of the risks. I had to make one of those decisions last Friday.

We had scheduled our Epic version 2014 upgrade for the weekend. The plan was to bring down the production system at 12:30 AM Saturday. The system would be down until 5:00 AM while the final conversion tasks were completed. IT and operations staff were scheduled in the command center to monitor the upgrade and address any problems. Leadership calls were scheduled daily to review issues starting Saturday.

At 11:51 AM on Friday, I got a text Continue reading

Importance of rounding or going to the “gemba”

In lean speak, you have to go to the “gemba”, that place where the work is done. GembaTo go to the “gemba,” I rounded with some of my colleagues in the early days of our inpatient Epic go live. They included our Chief Medical Informatics Officer (CMIO), the executive director of our children and womens hospital, and our Chief Nursing Officer (CNO).  We visited many different inpatient units – to listen to staff tell us how it was going and describe issues. It reminded me that I need to once again make time to regularly round with our users. Continue reading