On Technology

Physician satisfaction with EHRs

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I am a huge fan of Dr. Atul Gawande. Who isn’t? He is a surgeon, an author and one of the most insightful and influential physicians of our time. His books are best sellers and his articles in The New Yorker canstockphoto3914104 (1) physician computermagazine are widely read. He was recently named as CEO of the non-profit-seeking health care venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase to deliver better outcomes, satisfaction, and cost efficiency in care. He will be the opening keynote speaker at HIMSS19 in Orlando this coming February.

His books include Better, Being Mortal: Medicine and What Matters in the End, Complications: A Surgeon’s Notes on an Imperfect Science, and The Checklist Manifesto. I gave one of his early books to all my IT leaders one holiday season. My tradition was to give them an insightful and inspiring book each year. Gawande’s books are clearly some of the best for health care leaders.

Gawande has been a staff writer for The New Yorker since 1998. His latest piece was titled “The Upgrade: Why Doctors Hate Their Computers”. It’s a long read but worth the time if you work in health IT and care about your physicians. Gawande describes the challenges of EHR’s from the front lines of medicine. He talks about the significant amount of time spent doing documentation after a patient visit and the loss of physician to patient connection with the computer competing for attention in the exam room.

In discussing physician burnout, he referenced Berkeley psychologist Christina Maslach’s work studying occupational burnout where she defined burnout as a combination of three distinct feelings – emotional exhaustion, depersonalization and a sense of personal ineffectiveness. He noted that in 2014, 54%% of physicians reported at least one of the three symptoms compared to 46% three years earlier. He shadowed a scribe and talked with surgeons and primary care physicians on the impact of the EHR on their work and their time. He learned from a patient who works as a construction supervisor that others are also challenged in their work to make the necessary human connections. Continue reading →

Own your health

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That’s exactly what I did the past 6 months. And this week I graduated. From physical therapy that is. I’ve been cut loose. The next few months is all about me maintaining a daily discipline of stretches and canstockphoto15299929 (1) healthstrengthening exercises.

I first shared this journey in the post “Is there an app for that?” back in June. I also talked then about the importance of patient engagement and personalization.

I’m now around a 2-3 on the pain scale and closer to 2 most of the time. My physical therapist said if in a few months, I’m slipping back or feeling more pain I should get another prescription for more PT sessions from my PCP.

The stretches are much easier to make time for every day. There is short term gain plus a tangible benefit – I actually feel less pain. The strengthening exercises are harder to fit in, especially when I get busy or am travelling. With strengthening, there is no short term gain or tangible benefit – it’s all about the long term. Like going to the gym and doing weights.

The recent Fall ritual of raking leaves, bagging them, then carrying them to the curb led to a lot of pain. When I took care of my 2 ½ year old grandson and his 4-year-old sister recently for almost three days, all the lifting involved set me back. And I know the inevitable snow shoveling that is coming this winter will do so as well. My lower back muscles hurt just from all the coughing I’ve done the past 3 weeks with a bad chest cold.

My physical therapist says be sure to engage my core muscles at all these times and it won’t be so bad. I’m sure she’s right. I will try.

I am well armed with knowledge. I know what I need to do and how to do it. Will I slip backwards or continue to own it? Having lived with this low back and hip pain for years until it got so bad that I finally decided to get help, I know how bad it can be.

It’s now up to me. I need to continue to own it. As with any habit or exercise program, time will tell. Maybe an exercise tracking app or just an old-fashioned paper log is what I need.

Related Post:

Is there an app for that?

Apps aren’t enough

If not now, when?

Innovation or disruption?

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“You only call it a disruption because you didn’t create it – stop being disrupted, innovate.” That was just one of the messages in the opening keynote from Terry Jones at the fifth Annual Thought Leaders on Access Symposium (ATLAS) in Boston this week. His talk was titled “Turning Disruption OFF and Turning canstockphoto30429373 (1) innovationInnovation ON”.

As an entrepreneur with an impressive history, Terry Jones knows what he’s talking about. He is best known for founding Travelocity.com and serving as founding Chairman of Kayak.com. As consumers, we’ve experienced the disruptive innovations in the travel industry. As healthcare leaders, we were challenged by Terry to consider the innovations and disruptions yet to come in our industry.

ATLAS is a patient access conference for hospital and health system leaders sponsored by Kyruus for their customers and invited guests. Kyruus is a software firm that offers provider search, scheduling, and data management solutions to help health systems match patients with the right providers and enhance patient access enterprise-wide. This year’s theme was “Systemness. Ignited.” with excellent speakers on innovation and digital transformation in healthcare. The focus of the conference was on patient and consumer engagement. Health systems such as Banner Health and Piedmont Healthcare, leaders in transforming the patient experience, shared their stories.

It was inspiring to see so many healthcare leaders passionate about improving the patient experience. I’ve been in health IT management for decades and I was humbled to hear leaders from marketing, patient access, and innovation teams talk about getting things done in spite of roadblocks they sometimes face from IT. Continue reading →

Advancing healthcare through technology

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Healthcare is personal. Each of us knows stories of friends and family dealing with difficult medical issues. We hear how hard it can be to navigate the health system. It seems that one fills out the same information over canstockphoto21508588 (1) advancingand over and wonders why the physicians and hospitals don’t have it already. We hear how people must research their own conditions to make tough decisions about treatment options. We know there are access and affordability issues for many people.

As National Health IT week comes to an end, we must renew our commitment to make a positive impact on health care through technology.

I am fortunate to have worked with many passionate, committed people in healthcare over the past 30+ years. And I’m grateful to have a team of advisors working with us at StarBridge Advisors. Each has made an amazing and lasting impact on healthcare.

In our most recent StarBridge Advisors blog, “NHIT Week: 6 Leaders on the Value of HIT”, we discussed the value of health IT with six of our advisors. Their perspectives provide a lens into how technology is transforming healthcare though there is much more to do.

I encourage you to check out the perspectives shared by these CIOs and clinical leaders here. And if you like what you see, read more of our “View from the Bridge” posts and subscribe to receive notifications of new posts from our team of industry leaders.

Together, we all make a difference!

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Technology making a difference at scale

Predictions for 2018 – Our Future is Bright

A passion for healthcare

7 HIT blog and podcast recommendations

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I started blogging in 2014. It was a way to share experiences from many years as a health IT leader and to teach others. When I see the number of subscribers to my blog and 100,000 views to date, I think it’scanstockphoto58340963 (1) subscribe fair to say my blogs are having an impact. As long as that’s the case, I will keep blogging.

I was honored to see my blog named for the second year in a row to HealthTech’s Must-Read Health IT Blogger List. Here are some of the ones on that list that I plan to start reading more regularly:

Susannah Fox – She is the former CTO of HHS and covers a range of topics to help people and organizations navigate at the intersection of health and technology.

Inside the Mind of a Healthcare CIO by David Chou, Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City – I knew David was prolific on social media. I regularly read and share his content. But I didn’t realize that he was also writing a regular blog on a range of topics from his CIO experiences.

Health IT Buzz from ONC – This is a great way to keep up with what is coming from The Office of the National Coordinator and their perspective.

Health Populi by Jane Sarasohn-Kahn – I have met Jane at a few conferences in recent years and always find her insight and analysis to be very enlightening. She covers broad trends in healthcare. Something every IT leader should be tracking.

AAMI Blog – I may be biased as an AAMI board member, but I think all IT leaders need to be keeping tabs on what the issues are in the health technology management (HTM) world. Continue reading →

8 Signs of a strong security culture

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Cybersecurity incidents in healthcare are on the rise. Organizations are continuing to strengthen their security programs. canstockphoto45375611 (1) security culture

I am currently working with two clients who are focusing on security. One is a large regional organization that is hiring their first Chief Information Security Officer (CISO). They asked StarBridge Advisors to provide an interim CISO to help build the security program while they recruit. The other is a university health system that is consolidating their security program under the university CISO and hiring an associate CISO to focus on the health system. Both organizations recognize the importance of the CISO role and the need to continually strengthen their security profile.

While it may be surprising to see organizations hiring their first CISO in 2018, what matters is that they recognize the need and are making the investment.

When I served as CIO at Michigan Medicine for the hospitals and health centers, we crossed that bridge in 2015. The IT leader responsible for infrastructure had been responsible for security as well – not uncommon in healthcare organizations. I recognized that the security function needed a dedicated focus, so we hired a full-time CISO.

I engaged a third-party security expert to conduct an assessment using the NIST framework. As a CIO, I learned a great deal through that process. With the help of our consultant, I was able to educate the executive team as well.  One component of the final assessment report was about creating a security culture.

Security cannot just be the job of the CISO. Continue reading →

What does a high value conference look like?

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Last week I had the opportunity to speak on two panels at a different kind of conference. HealthIMPACT East was held in Washington DC. The first day was solely focused on social determinants of health canstockphoto5296053 (1) conference(SDoH). The rest of the conference was on population health, interoperability, patient centered design, innovation, and blockchain.

The conference organizers and facilitators focus on what they call “purposeful events” with “no BS and no PowerPoints”. Instead of speakers talking “at people”, they facilitate lots of conversation in a room of full of smart people. The format was mostly panels with several excellent individual speakers who did use slides. The organizers want the conferences to be an idea exchange among a community of leaders and encourage dynamic debate.

The overall number of attendees was small. But it facilitated thought provoking discussion during each session and deeper networking connections at meals and breaks. I wasn’t tempted to pull out my iPhone to check my email as presenters talked through slide after slide. Instead, I was asking questions of the experts and engaged in the discussions.  The track facilitators did an excellent job getting attendees engaged.

When I walked in, I only knew two people – Megan Antonelli, CEO HealthIMPACT and CEO/founder of Purpose Events Group, who had invited me to speak, and Nick Bonvino, CEO at Greater Houston Healthconnect and a frequent speaker on interoperability. Continue reading →

Is there an app for that?

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Have you ever experienced chronic pain? Did you try to ignore it and push through it? Or did you see your doctor and hope for a resolution?canstockphoto12572942 (002) joints

We expect quick fixes when something goes wrong. Yet chronic pain may mean physical therapy and daily exercises to strengthen certain muscles and address the cause of the pain. Far from a quick fix!

That’s what I’m going through now and at times my patience and discipline are low.  I’m supposed to do a series of focused exercises twice a day. I am trying to take the long view. Just like my shoulder surgery for a torn rotator when I had to do physical therapy for 6 months.

If I think I don’t have time for the exercises or I just don’t want to do them, I tell myself this is what it will take to relieve the back and hip pain I have been living with. No one is just going to fix it for me. Yes, my physical therapist will assess my pain level each visit, ask me how the newest exercises are working out, and determine what to add to my routine. But it’s on me between visits.

I’ve had four visits and try to schedule one once or twice a week. I know the time will come when the time between visits gets longer. And then she will tell me I’m on my own. It will be the true test of whether I own this or not. Will I make the time to do the exercises twice a day? Will I feel my slow progress and realize it’s working?

It’s like flossing your teeth, you need to own it. You can’t just do it for a few days before your teeth cleaning appointment – you have to make it a daily discipline.

I asked my physical therapist about studies on patients not doing their exercises at home. I told her about my experience of owning it after shoulder surgery. She asked me if I was owning this. I said I was getting there – trying to have the long view because I don’t want to live with pain. We need to own our own health. I can’t complain about the pain if I’m not willing to do my part.

We had a good chat. She described how her role is to help patients be successful. She has learned to not give too many exercises, or the patient won’t do them. If the patient hates the exercise, she knows they won’t do it. She has to find an acceptable alternative. And she emphasizes patient education. Continue reading →

Celebrating, collaborating with, and learning from HTM

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Two weeks ago, it was National Nurses Week. This week is Health Technology Management (HTM) Week. If you work in a hospital, you may still refer to HTM as Clinical Engineering, Biomedical canstockphoto16403307 (1) HTMEngineering, or just Biomed. Regardless of what you know this department as, they are some of the unsung heroes in every hospital.

The nurses and physicians know these heroes well. The C-suite is recognizing their value more all the time. And IT departments are learning to work collaboratively with them as systems become more integrated.

These are the staff who design, install, maintain and repair the medical devices that connect to patients. Just think about a patient in an intensive care unit surrounded by all that equipment and all those connecting tubes and wires. If those of us in IT think we’re important and critical to the hospital, HTM staff are life critical to the patients.

As a CIO, I’ve always told my IT teams that we are part of the extended care team to emphasize the importance of our providing 24/7 support and excellent customer service. While we don’t touch the patient, the clinicians who do depend on the systems we provide and support. This is even more true for HTM staff.

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

While healthcare organizations recognized their HTM staff in various ways this week, June 1-4 will be a chance for HTM professionals to come together for education and networking at the annual AAMI conference in Long Beach. Continue reading →

When innovation means plan B

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It was already Thursday morning and I had no blog topic in mind for this week. By Thursday night I had several. So, what happened in between?canstockphoto6581040 plan b

I attended the New England HIMSS Chapter’s Annual Spring Conference – something I’d planned to do for a while. On my way there, I figured something that day would light a fire and I’d have a topic to talk about. Instead, there was a different kind of fire.

One of the chapter board members called me in the car and said she had heard I was on my way to the conference. I thought to myself, I’m stuck in traffic and may get there after the opening keynote starts, but did I have to admit that to her? No, that was just my guilt about leaving the house 15 minutes later than I should have. She was calling for a “small favor, no actually a big favor” as she said.

Turns out one of the afternoon speakers had gotten stuck in New York with flight cancellations and couldn’t make it. So, a panel with 3 chapter members was being hastily put together – would I be willing to participate? Of course I would. I said yes without knowing what we’d talk about or who else was being asked to be on the panel.

Two other panelists were being enlisted in that same rush of phone calls and conversations. Arthur Harvey, chapter board member and CIO at Boston Medical Center, had already arrived at the venue. He was of course very sympathetic to the dilemma and ready to help. Arthur and I were on the CIO panel together at the 2017 spring conference. He was already starting to percolate on a relevant topic we could address. Dirk Stanley, CMIO at UConn Health, was on his way to the conference from Connecticut and got a call like mine. I only knew Dirk from social media, so I was looking forward to meeting him in person.

When I arrived at the conference and was greeted warmly by board members who were pulling this backup plan together, I asked which speaker had to cancel and what was their topic. Answer: Blockchain. I laughed and said, well we’re not doing a panel on blockchain. Continue reading →