HIMSS Stage 7: what does it take?

This week, I participated in another HIMSS Analytics Acute Care EMRAM Stage 7 review team as the CIO reviewer. During the opening presentations by the organization’s leadership, I leaned over to theHIMSS EMRAM 2018

full-time HIMSS reviewer to say, “They are hitting it out of the ballpark”. By the end of the day, our three-person review team had indeed reached that conclusion. The full-time reviewer said, “Some organizations barely clear the bar but this one far exceeded it.”

Only 6.1% of hospitals have achieved Stage 7.  What does it take?

On review day, the review team is presented with information that includes a system overview, including governance, clinical and business intelligence, health information exchange, and plans for disaster recovery and business continuity.

The review team has been given a 17-page document that includes checklists for each major clinical area.

Several case studies are presented that demonstrate how the organization has used the system to improve clinical care.

The organization prepares for this visit for months, developing the case studies and verifying they have met every specific criterion. The full-time reviewer spends time on the phone reviewing their readiness.

Achieving Stage 7 takes teamwork throughout the organization to fully leverage all aspects of the vendor’s product. It takes engagement and passion from executives and clinicians.

The organization we were reviewing implemented their EMR according to these guiding principles: Continue reading

WANTED: STEM gift ideas for kids

November 8th was National STEM Day. A great way to raise awareness about the need for STEM education. But we need more than one day to remind us of the importance of STEM education. Especiallycanstockphoto36568604 STEM for girls. The number of women in STEM fields continues to lag men. My current favorite TV commercial is the GE one with Molly the young inventor – great inspiration! 

I’m a firm believer that you need to create an interest in science and encourage children, in particular girls, starting at a young age. There are many ways to do this. The choice of toys, games, and books is just one of them.

The holiday season and gift buying is ahead of us. In my case, it’s not just the holidays but it’s also two birthdays. I’ve been asking my daughters what to get for my soon to be 3 and 5-year-old granddaughters for their birthdays. The soon to be 3-year-old is consistent in her answer no matter who asks – a red motorized toy car so she can drive her younger brother around the yard. The soon to be 5-year-old answered a My Little Pony or Hello Kitty toy set. For Christmas last year, we bought her several months subscription to Koala Crate, an activity kit for kids age 3-4. She loved it and her parents continued the subscription.

I’m committed to finding some educational toys for them for either their birthdays or holidays so I’ll be checking out the STEM section of the local toy store again this year.

When I started writing and speaking on women in technology a few years ago, I put together a list of STEM toys for different ages. This was done with the help of one of my staff who had two young daughters and shared my passion about STEM education. I know this list needs updating and I could use your help.

So here’s my ask – take a look at my STEM for the holidays blog post from back then and send me your more current suggestions via a comment so I can share with all my readers. Think all ages from toddlers through high school. If I get enough new suggestions, I’ll create an updated list to share before the holidays. Thanks in advance for your help!!

Related posts:

STEM for the holidays

Yes you can: encouraging girls to pursue IT careers

Technology, where are all the women?

Working remote: self-sufficiency required, collaboration a plus

I woke up Monday morning after a sleepless night with a text from my daughter, Ann, “do you have power?”. Only 10 miles from our house, her neighborhood had lost power and Internet access due to the Lunch Learn Graphicstorm while we were up-and-running. Ann works from home as Communications Manager for a national company, and was not interested in wasting a sick day sitting in the dark. So after dropping my granddaughters off at daycare, she set up shop in our dining room.

Except for being limited to just her laptop and not the two large extension monitors in her home office, she was ready for a productive day. A year ago, I would have thought she was crazy for needing two monitors, but she convinced me to get a second. There’s nothing like it for multi-tasking and having multiple windows open when you are working on a project.

We respected each other’s space and work. We had minimal conversation when I went to the kitchen for coffee. But in our two brief morning interactions, we casually discussed the common challenges of remote workers – one being the isolation. And I got some new ideas from her.

Half the dining room table was covered in my receipts as I was working on expense reports. I used to just hand the task over to my executive assistant, but in my new life, I do them myself. I dislike the task so much that I get way behind. Monday was the day to catch up. Continue reading

Something new every day

As an entrepreneur with my own business I am required to learn more new things than I ever imagined. That includes new software tools – and lots of them.canstockphoto14781905

Our firm uses SalesforceIQ to track prospects and clients. This tool has so much flexibility and is so easy to set up that we have found many additional ways to use it. Our virtual admin sets up the basics for us once we provide requirements; we then maintain the data. It’s so easy and intuitive that I have made changes myself that in another system would require a programmer. SalesforceIQ gets high marks from me!

We’ve been leveraging LinkedIn as a business which has meant learning about functions individuals don’t need to use. We have needed expertise from our LinkedIn support person and then our virtual admin to implement. But it’s been fun to learn what’s possible and figure out how best to leverage it.

Then there are those basic Office 365 tools. Maybe you have a love / hate relationship with them. I do at times. Sometimes, you hear the term “bloatware” for products that are so feature rich you couldn’t possibly use them all, much less figure them out.

Anyone in management knows the basics of Word, Excel, and PowerPoint. But do you really know how to use all the advanced functions? Or do you turn it over to a staff person at some point to do that level of manipulating? What you think should be intuitive just isn’t much of the time. Or maybe I’m just showing my age.

But I keep at it and learn as I go. I just need to recognize when it’s diminishing returns and ask someone for help. I shoot off a note to one of my colleagues or our admin. My husband is probably happy that he can’t be my “next door office support person” for these kinds of questions; he uses all Apple products. Continue reading

HIEs matter

We have watched with sadness as Hurricane Harvey has flooded first southeast Texas and now Louisiana. We have seen the spirit of the American people at its best. Volunteers from around the countrycanstockphoto30688369 have brought their own boats to rescue residents while thousands have donated money and supplies. As of Thursday morning, there had been over 25,000 water rescues.

Hospitals are meant to operate and care for patients 24/7 through a disaster. But they too were impacted by the rising waters. I took a break mid-day yesterday to watch the news. I saw in that 15-minutes the evacuation of patients from Baptist Hospital in Beaumont, Texas after the city lost its water supply. Without clean water, the hospital had to close and transfer 190 patients.

Patients, many in wheelchairs, needing dialysis treatment were being boarded onto Black Hawk helicopters by teams of doctors and nurses. They were being handed over to military medics to be flown to a hospital in Jasper, Texas – 70 miles away.

The last step in the transfer process was a clinician giving a folded-up paper to the medic. She had stuffed it under her shirt until that point so it didn’t blow away in the wind from the helicopter propellers. We know that this critical paper handoff probably happened over and over this week as patients were transferred to other facilities.

In this age of electronic medical records (EMRs) and health information exchanges (HIEs), we hope that piece of paper is a backup document. Transfers within a health system with a common EMR should be able to rely on the system for access to critical patient information. Health systems that participate in HIEs should be able to rely on some level of data exchange and access between health systems and their disparate EMRs.

I was encouraged to see two health IT articles this week – “As Harvey Devastates Houston, HIE Leaders Move in to Help” in Healthcare Informatics, and “What’s Next for Health Information Exchanges?” in Healthcare IT News. The first article describes the power of the HIE in Texas; portals have been set up in the many shelters so clinicians can access critical health information as they care for people in need of medical attention. The second article talks about the future needs that HIEs could meet and their potential benefits as healthcare continues to evolve. Continue reading

8 tips for telehealth success

Telehealth or connected health as some call it, takes different forms depending on the provider organization and their strategy. The primary driver may be extending geographic reach by providing canstockphoto40754495telehealth services to rural areas. Or it may be largely a focus on consumer engagement.

Regardless, there are common themes for successful initiatives. Based on my experience in several healthcare systems in recent years, I offer these tips for success:

Strategy is key – The organization must first determine what the key drivers are for the initiative. Is it to extend reach or provide an easier patient experience or a combination?

Tactics and specific programs will follow – Once the strategy is clear, which specific clinical services and offerings are needed the most will become clear.

Physician leadership is needed – If the focus is on extending reach of certain clinical services, physicians are at the center and must provide overall direction. For consumer-focused services, ambulatory services or strategic planning leadership may play a more central role.

Operational issues and decisions must be considered early on – There are legal and billing factors along with workflow issues for clinicians and staff to work out before any implementation. Continue reading

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

Walking in a nurse’s shoes

National Nurse Week begins tomorrow. I’m fresh off a 4-hour shift shadowing a nurse on a busy inpatient unit with cardiac surgery patients. I was taking part in the “Walk in My Shoes” program at Stony Brook Sue in scrubs cropped (2)Medicine where I currently serve as interim CIO.

All the executives were asked to block out 4 hours this week to shadow a nurse. I looked forward to my shift despite the other work on my desk. And as I told the nurse I shadowed, spending time on their unit was more fun than some of the problems I deal with as a CIO.

But I wasn’t there to have fun. I was there to understand what a nurse’s day is like and find ways that administration can help. And as the CIO, I wanted to understand how they use the systems we support and to find opportunities to improve them.

I donned a pair of scrubs, the universal hospital uniform and a fashion neutralizer. It’s amazing how different it feels to be on a nursing unit in scrubs compared to being a “suit” who periodically does rounds with a bunch of other “suits”. The staff seemed more willing to just tell it like it is when I encouraged them to be candid with me.

As soon as got to the unit a nurse realized I was from IT. His first thought was that I was there about a system problem that had been reported in the patient safety system. I introduced myself and my role as interim CIO. I told him that while I was there to shadow another nurse, I wanted to hear about their IT issues.  This was my “gemba” walk with a group of nurses. Continue reading

What to expect from your vendors

You are past the big go live. You and your team are focused on optimization, enhancements, ongoing support issues, and upgrades. So, what should you expect from your vendor in this ongoing relationship?canstockphoto10856287

I have worked with all the major EHR players and many other IT application and infrastructure vendors over the years. I have worked with three of the major EHR vendors just in the last 18 months given my interim CIO engagements.

My post “Keys to successful vendor management“ covered the importance of the product roadmap, service, total cost of ownership, reputation, contract, implementation, and escalation.

It’s time to look at the ongoing vendor relationship that clients should expect. Vendors, take note. I assume most of your clients would share this view. There’s a reason that the KLAS Research reports carry a lot of weight for CIOs, they are vendor evaluations from their peers.

Whether it is a large, proven vendor or a small start-up, here’s what you should expect: Continue reading

HIMSS17 – It’s a wrap

There could be as many different wrap-ups on HIMSS17 as there were people there – over 42,000. No one sees the same vendor exhibits, hears the same presenters, or talks to the same people. There are HIMSS17 sign ver 2conferences within conferences. So here’s just one wrap-up – mine.

The first speaker I heard did a great job of scaring all the CIO’s. Kevin Mitnick, the world’s most famous hacker and security consultant, and author of several books including his most recent one, The Art of Invisibility, was the opening keynote at the CIO Forum on Sunday. His talk, “The Art of Deception: How Hackers and Con Artists Manipulate You and What You Can Do About It”, included real-time demonstrations. He drove home the point about how vulnerable we are as individuals and organizations.  I highly recommend checking out his website to learn more or get scared yourself.

Dr. B.J. Miller was the final speaker at the CIO forum. His talk, “What Really Matters at the End of Life”, was a very sobering view of palliative and hospice care yet strangely inspiring at the same time. As he said, “Spending time thinking about your time on the planet while you have time is important – don’t wait.” I highly recommend listening to his Ted Talk with this same title.

I have been asked to serve on the CHIME Education Foundation Board again so Monday morning meant a board meeting. Continue reading