Strategic Informatics

A blog about the strategic application of technology

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American Healthcare

So I came across this infographic on Business Pundit and thought I would share.  It’s a great example of where things have headed south in American healthcare…  I use several of these statistics on the incredible rising costs and disease states in my speeches on healthcare IT, but a few stood out.  Specifically the lack of funds being directed to preventative services like Home Health…  Almost 50% of all deaths are related to only two disease categories…  Heart Disease and Cancer.  While there is not yet a cure for cancer there are preventative measures Americans can take to reduce their risk of Heart Disease, and chronic respiratory diseases…  We are a privileged nation with a lot of luxuries afforded to us but we have to start taking care of ourselves and change our habits otherwise the trend of costs and burden on our system will continue its sharp upward trend.

The Per capita spending never ceases to amaze me… but putting it into tangible real-world examples makes a big impact.  Would you pay $95,526 for a Volkswagen Beetle or $176.58 for a family dinner?  How far could you get when gas is $13.50 a gallon?

American Health Infographic

Enjoy and thanks topmastersinhealthcare.com for putting this together.

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Certified ScrumMaster

I wrapped up training two weeks ago to be come a Certified ScrumMaster.  The course was a solid foundation on the fundamentals of Scrum and the process of product management and development in an agile environment.  While I’ve participated in Scrum sessions many times in the past this formal indoctrination into the process was very insightful and will prove very useful in future meetings with teams.  Most sessions you see in practice are variations of the real process which, to the Scrum Alliance’s credit, has evolved and been refined over the years is actually very good.  With some effort, practice, and discipline of your teams the breakdown of product backlogs, into deliverable sprints could prove fruitful for any product focused company.

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Presentation on Accountable Care Organizations at the San Antonio HIMSS Chapter September Lunch & Learn

 

I was given the opportunity to speak at our local HIMSS Chapter September Lunch & Learn session held at Dave & Busters.   The presentation was on “The Role of Accountable Care Organizations in the Evolution of Healthcare”.  In working with our chapters Program Director we thought a broad topic that encompassed many aspects of healthcare delivery would be a great way to kick-off our foundation series and serve to lay an educational foundation for our chapter members.

 We plan on offering this presentation and that of our other speakers on our website (www.sahimss.org) soon so stay tuned.  If you weren’t able to attend you can grab a copy of my presentation by clicking here.  I discussed a variety of topics specific to ACO’s including recent healthcare reform models, ACO formation,  care model and medical management capabilities and their impact on Healthcare IT (HIT).

It is clear to me our membership is interested in the impact of healthcare reform given the questions and interest after my presentation.  This is exactly the kind of dialog we wanted to create as our next several foundation series will focus on tertiary topics such as Health Information Exchanges, Medical Informatics.  Additional topics will include the EMR deployments & utilization in other countries, and military healthcare which San Antonio has a strong presence.

As always we love your feedback and I would encourage you to send us a message through the San Antonio HIMSS Chapter website (www.sahimss.org).  Don’t forget to register for a future event to secure your place.

 

 

 

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Book Review: REWORK

I just finished reading one of the most refreshing books I’ve come across in quite awhile.  The team from 37signals offer up a great perspective on creating a fast moving agile organization that focuses not on one-up’ing your competition but delivering services or products that actually make a difference to your employees and customers.  To borrow from the book what you don’t do is just as important if not more so as as what you do decide to offer in a design, product, or service.   Fried and Hansson show how easy it is to get lost in the mainstream of today’s larger organizations and how many organizations become handcuffed by many of the typical notions of how business should be run.

 

 

Rework offers a refreshing series of essays covering a variety of topics many startups and nascent entrepreneurs would be wise to follow.    From the cultivation of a “culture” to the core of what drives your business…the people and hiring those who are really driven and will help your organization grow by sparking a passion and desire to build not just profitable but exciting organizations your employees and customers can get behind.

You can find Rework on Amazon here

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Texas Regional HIMSS Conference

Just kicked off the Texas Regional HIMSS conference in Austin, TX.

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US Healthcare vs. The Rest of the World

Medical Costs Infographic
Via: Medical Billing and Coding

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User Interface Design using Silverlight Rich Internet Application (RIA) Technologies

March 16th will mark one year since we generated our first formal wireframe comp for what has now become a very robust enterprise application for physicians and their clinical staff.  This journey through building an initial prototype, development of a solid service oriented architecture,  building the project, analyst and development teams, generating a solid user experience, engaging our customers and more importantly engaging everyone in a new agile methodology has been nothing short of an amazing journey to which I’m very proud of what we have all accomplished.  As we approach formal implementation of a project kicked off just one year ago I would like to recognize some great vendors who helped us along our journey…  Xby2, Seamgen, and Cynergy Systems and especially my development staff at WellMed who kicked us off in this new agile development effort.

My recent visit to HIMSS ’11 in Orlando, FL validated what I already knew…that our user interface, which sits atop the underpinnings of a service oriented architecture, is far and away more usable and interactive than anything else on the market today.  The tool our customers use does not need to get in the way of doing business…  Cynergy Systems has created a showcase video highlighting their approach to User Interface design with our product and shows how good UX design can go a long way in helping ease complex tasks.  Below is the showcase video they produced and demo’ed at the Health Information Management System Society (HIMSS) meeting last month.

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Doctors embracing iPads as a clinical tool

Wendy Rigby with KENS 5 News San Antonio just finished an article on iPad use in clinical settings and focused on the effort of our WellMed physicians.

Credit: Wendy Rigby / KENS 5
Dr. Robin Eickhoff of WellMed uses an iPad as she consults with her patient

The article highlighted our EMR and Care Delivery Platform development efforts and our President, Dr. Carlos Hernandez, mentioned something quite profound during the video interview this afternoon that wasn’t captured in the article or on the video and that is the “need to develop tools built around care delivery not delivering care around a tool” which is precisely what our application development efforts have focused around.

Our Service Oriented Architecture has enabled us to quickly embrace change in the mobile space.  The iPads have not been out an entire year yet we are able to quickly consume the core secure EMR services built into our flagship Care Delivery Platform and push data into the hands of providers using a very connected, very mobile device with a fundamentally different user interface.  By taking the time to develop and invest in a service oriented architecture we’ve prototyped this iPad app in a fraction of the time it has taken to develop our RIA (Rich Internet Application) EMR.  This has been a long and often exhausting journey to leverage and get to a state of reusable services but the goals of being more agile and leveraging on top of what is already built is a refreshing feeling and enabling WellMed Medical Management with opportunities to remain agile in our ability to deliver on strategic decisions and changes that benefit care for our seniors.

To check out the article and photos of physicians using the iPads within the clinic check out the link on KENS5:

http://www.kens5.com/news/Doctors-embracing-iPads-as-a-clinical-tool-115957794.html

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Social Network Data Visualization

Linked-In Labs has a new data visualization feature that shows the links between your different contacts and relationships within LinkedIn.  Simply log-in to inmaps.linkedinlabs.com and you can see the relationships unfold.

Above is a copy of my map of contacts and their corresponding relationships primarily in the healthcare and IT fields grouped by relationship types, affiliations, and general experience domains.  You can find other inventive concepts at www.linkedinlabs.com.

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Designing an Electronic Medical Record

Some big ideas come from asking pretty simple questions…

As it turns out the inspiration and vision for the development of an innovative Care Delivery Platform at WellMed was born out of necessity.  A necessity to accurately and efficiently deliver timely information about patients health status to caregivers at the point of care and document in a way that did not inhibit the caregivers ability to deliver quality care to seniors.

Many physicians are burdened with a mass of paperwork detailing patient activity.  The simple idea of putting relevant and timely information in the hands of a physician when it is most important to help manage risk and provide adequate decision support at the point of care is a goal many EMR vendors have tried to achieve by simply aggregating and archiving data.  There are several decision support tools available for physicians that manifest themselves in different ways such as ePrescribing applications, Reference Material, Patient Education Handouts, Risk Adjusted Payment Attestations, Document Management Repositories, Clinical Protocol sheets, etc… some within a single application, many others completely disconnected and disjointed requiring the user to log into multiple applications to perform seemingly simple functions.

When you think about it clinicians and many tertiary healthcare providers live and work in an environment where the vast majority of documents sent and received are in paper form and it is still growing.  When you add electronic information in the form of e-mail, document management systems, and patient data to the mix it becomes inefficient and cumbersome for providers to effectively manage.

We’re two decades into the internet revolution, and despite many efforts to create an all electronic clinic, paper is still the predominant method of healthcare communication in this country.  It’s 2010 and many providers get their documents more or less the same way we did 200 years ago!!!

That’s absurd…

While we can’t change an entire industry we can start by looking at ourselves and how we deliver healthcare to seniors.  When I started with WellMed 2 years ago I was inspired by our CEO’s vision and approach to wanting to leverage technology to gain efficiencies and better manage risk for our patients to keep them healthy and out of the hospital.  At the same time I saw his frustration with current solutions that did not allow us to progress to the next level of patient care.  The truth is we will never completely get rid of paper, this is a common misnomer, but we can manage it more effectively and make it more accessible to clinicians.  What the our clinics needed was a new, complementary approach for managing patient information.

So here is the simple questions that led to the creation of the Care Coordination Platform:

What would it take to deliver quality information to physicians at the point of care?

What would empower physicians to help deliver quality care for seniors and help improve outcomes?

After much thought and effort we think we’ve got an approach that nails these things.  It brings efficiency, new benefits for both business and physicians and more importantly our seniors.  So far the feedback and the demand for a solution have been terrific.

As we get ready to bring the solution we started developing a year ago to physicians we will continue to evolve the platform to include many other data elements in the patients continuum of care.  We have not been sitting idle and have solicited feedback from many providers and will continue to be engaged with all users of this new system.  Initial feedback has been great and we’ve got lots more work ahead, but we are off to a great start.

When we introduce the EMR Preview in 1Q 2011, it will have exceeded our current EMR functionality in many ways and plan on quickly following with quarterly releases of additional functionality including ePrescribing, and document management integration in subsequent iterations.  I’m very proud of what our team has created in such a short amount of time and will continue to develop as we forge new ground and develop new integrations with other custom and vendor solutions.  I would love to show you more than just a teaser image as the user interface takes full advantage of rich internet application (RIA) functionality.   I truly believe what we have designed will empower our providers to delivery quality care to seniors.  Until such time we make our internal development efforts widely available to contracted providers I will instead focus future posts on our approach to architecture, user interface, SOA, and agile development.