Tag Archives: healthcare

Merger mania – is it good for the patient?

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In just the past few weeks, we saw several major healthcare merger announcements – Dignity and CHI, Advocate and Aurora, Ascension and Providence St. Joseph Health on the provider side. And then there’scanstockphoto18678854 CVS Health and Aetna – a potential disruptor in the healthcare market. And we don’t yet know what other market disruptors like Amazon or Google might do in the healthcare space.

There have been predictions in recent years that eventually there would be just 10-15 major healthcare systems in the U.S. Are we on our way to that prediction with the latest merger announcements?  The combined Advocate and Aurora system would create a 27-hospital healthcare system in Wisconsin and Illinois with projected annual revenue of $11 billion. The Dignity and CHI merger would include 139 hospitals in 28 states. If Ascension and Providence St. Joseph Health merge they would create the largest hospital chain with 191 hospitals in 27 states and annual revenue of $44.8 billion.

What is driving these mega mergers? The announcements about them talk about improved access to care, improved outcomes, lower costs, sharing best practices and overall being more prepared for success in the changing healthcare market and landscape.

Jane Sarsohn-Kahn, health economist, wrote a great piece earlier this month – “Will Getting Bigger Make Hospitals Get Better?”.  She talked about the value that matters to patients — the trust that is needed between hospitals and patients.

And what are the IT implications of these mergers? If markets don’t really overlap, what degree of system integration is needed? Is one seamless patient record needed as it is for large regional systems with a lot of patient movement between community hospitals and specialists at academic medical centers? Continue reading →

One year anniversary, how are we doing?

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For the first birthdays of my four grandkids, there have been party hats and “smash” cakes. But what does a small team of entrepreneurs do on the first anniversary of founding their firm? They take stock and plan canstockphoto48088945for year two.

David Muntz, Russ Rudish and I launched StarBridge Advisors in October of 2016. So how does a health IT advisory firm measure success after year one?

Number of clients – We have already assisted 12 healthcare provider organizations with some repeat engagements and have national reach.

Revenue – Any first-year projections can be a crapshoot but you need to start somewhere. We may have been overly optimistic but we are well on our way with our client base and pipeline.

Size of our team – In addition to our three principals, we now have almost 20 advisors on our team available for interim management, leadership support and consulting. Their IT leadership experience includes serving as CIO, CTO, CISO, CMIO or CNIO in healthcare organizations.

Channel partners – We work closely with several larger consulting firms who offer services that we don’t. We partner with Healthcare IT Leaders, a leading staffing firm and Rudish Executive Search, which specializes in healthcare.  And we are working with a few start-up technology vendors who are bringing to market new and novel solutions for healthcare providers.

Referrals – Our principals combined have over 90 years of experience in the healthcare industry. Our relationships are a key component of growing a new business and getting known in the market.

Name and brand recognition – A year ago we had decided on a name and incorporated, but had yet to figure out our branding. That was some fun work at first; by January we launched our website and social media presence. Continue reading →

Humanitarian crisis, American crisis

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A week after Hurricane Maria devastated Puerto Rico, we are hearing that this United States territory is facing a humanitarian crisis. That is a phrase we have all heard before about poor countries in other partscanstockphoto18234898 of the world – it could be the result of a natural disaster or a civil war. A crisis like this saddens us, but it’s usually so far away, and we just move on.

What is a “humanitarian crisis”? Wikipedia defines it as “a singular event or a series of events that are threatening in terms of health, safety or well being of a community or large group of people”. Another way of saying it – when the basics of life are unavailable – food, water, transportation, healthcare, and communications.

Puerto Rico is us, yes US. It is not somewhere far away. It is 1000 miles from Miami. 3.5 million people live in Puerto Rico. It is 3 times the size of Rhode Island – in square miles and in population.

Less than 50% of Puerto Ricans have running water. The entire island is without power, the power grid has been destroyed. Only 29 of 69 hospitals on the island are operational. Hospitals still open are running on generators and quickly running out of fuel. In the capital city of San Juan, 2 people on life support died when their hospital’s generators ran out of diesel.

Interviews with San Juan Mayor Carmen Yulin Cruz on MSNBC brought this home. She could not have been more articulate in her plea for federal help. As she talked about the dire situation and the reality of hospitals running out of power, she described them as places to care for and heal people, not to be death traps.

Luis Guiterrez, U.S. Representative from the Illinois 4th congressional district, whose parents were born in Puerto Rico described in vivid terms what the elderly are going through there. He asked us to think about what it would be like for our own elderly parents who may live alone. What if they didn’t have access to food or water and they needed insulin. He called for the U.S. military to go in and quickly set up a power and communications infrastructure as we know they can and do in wartime.

The USNS Comfort is larger than many of the largest hospitals in this country with 1000 beds. Continue reading →

Culture matters in mergers   

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If you live in a large metropolitan area, chances are you have been either a patient or a visitor in an academic medical center that has 500 to 1000 beds. If you live in a rural area, you are probably more canstockphoto8191068familiar with a small local community hospital with less than 100 beds.

Because of healthcare mergers and acquisitions, these two different kinds of hospitals are likely to be part of one integrated health system. While different in size and scale, they both deliver healthcare to their community 24×7.

Small, independent hospitals are often very agile, extremely customer service oriented and supported by a loyal community. In IT, the staff are often generalists and less specialized. They may have a single integrated system from one vendor with basic functionality and limited integration points with other applications.

In contrast, large academic medical centers can be slow to make changes and appear more bureaucratic. They provide advanced medicine with subspecialists and clinical services not found elsewhere. They have to work harder to create a culture of customer service. Their community is broader and they attract patients from greater distances, including international patients. And their IT teams are larger with many specialized roles. In addition to their core electronic health record, they have many specialized departmental applications, many interfaces. Overall, it’s a far more complex environment.

So how do these different profiles mesh at merger time? Continue reading →

8 tips for telehealth success

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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 →

Different organizations, common IT challenges

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I had the opportunity to participate in the CIO panel at the New England HIMSS Chapter Spring Conference this week. The questions for the panelists covered a range of issues that currently challenge canstockphoto5451287healthcare CIOs.

Some were:

  • how mergers and acquisitions impact IT;
  • how to improve patient engagement given the move to accountable care models;
  • how to provide growth opportunities for our teams and;
  • how to find time and resources to drive innovation.

I have been a CIO in a few different healthcare organizations recently, so I could describe multiple experiences with these challenges. While we have similar internal drivers, and face similar external constraints, no two organizations are the same.

These questions connected well with some of my focus areas during this current interim CIO engagement at Stony Brook Medicine. After about a month in the role, I summarized what I thought to be my focus areas and shared them with the executives. The feedback was that it was ambitious but on target.

Here’s that list. It’s generalized so you can consider it a good sampling of what interim CIOs can do for an organization, and what other CIOs may be focusing on: Continue reading →

A tale of patient advocacy

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We have two little dogs. Pepe is a 10 year old Shih Tzu/poodle and Coco is an 8 year old Shih Tzu /Bichon.  Pepe had been getting frailer and weaker throughout the Fall months. IMG_2946 (002) waiting at the bus stop

We thought this might be her last year with us. But her blood work in November showed that she has a thyroid problem.  She now gets a daily medication and has more energy and no longer sleeps most of the day. The name Pepe (as in peppy) is fitting her again.

She had also been losing weight and getting very thin. So, we started her on canned food. Maybe she had  a problem with the dry food she has always eaten. Or maybe Coco, who is dominant, wasn’t letting her get to the food dish. What dog or cat doesn’t love canned food??? Pepe loves it and has been gaining weight. While my husband and I are still getting used to that nasty moment when you first open the can of wet food, we do it because we love her and want her to gain weight and get strong. It’s working.

When we recently took Pepe to the vet to deal with a digestive problem, the vet found she had a broken tooth and the area around it was inflamed. She would need surgery to have it pulled. That happened this week and all is well. She is even back to eating treats that take some chewing. In hindsight, the broken tooth could have been the reason she stopped eating the dry food.

Animals can’t talk or “use their words” as we tell small children, so it’s hard to know when something is wrong. And it’s hard to know the interconnections between all these issues. Continue reading →

HIMSS17 – It’s a wrap

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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 →

Countdown to HIMSS17 – Part 3: Networking

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The countdown to HISS17 is in the final days. As I wrote the past two weeks, the best way to think about your prep for HIMSS17 is in three ways – education, vendors, and networking. This post is the last in a canstockphoto6370084three-part series – focusing on networking. It has to be the last, you’ve probably finalized your schedule for education and vendors. Now, you’re thinking about what to pack at this point. For us Northerners that means pulling out some summer like clothes and shoes – I’m looking forward to that part!

Have you been to HIMSS conferences before and know tons of people in the industry? If so, networking is probably not an issue for you. Are you relatively new to HIMSS conferences and want to make a lot of new connections? If yes, then this post might be useful.

I know a few things about networking.  After all, one of my daughters’ nicknames for me is the “network queen”. Here are some tips to consider:

Scheduled receptions and meetups – There are plenty of these including an orientation for first time attendees, opening reception for all attendees, local chapter events, vendor receptions, and topic focused Continue reading →

Countdown to HIMSS17 – Part 2: Vendors

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The countdown to HISS17 continues. As I wrote last week, the best way to think about it is in three ways – education, vendors, and networking. This post is the second in a three-part series – focusing on vendors.canstockphoto10546354

If you already registered, you have been inundated with vendor emails and snail mail since then. The ginormous exhibit hall beckons when you get to Orlando. So how do you make the vendor aspect of HIMSS17 as productive as you can?

Here are some tips to consider based on many years of navigating the exhibit floor:

Meeting with your current vendors – I’ve talked with colleagues in the past who always start here. They schedule meetings in advance or stop by just to say hello at all their primary vendors’ booths. I never fully understood this. Maybe I was a CIO in an organization with mostly internally developed systems for too long. You can connect with your primary vendors throughout the year so do you really have to spend a lot of time with them at HIMSS? It’s up to you and your specific needs and issues. If you want to see the Continue reading →