Tuesday, October 11, 2011

The BIDMC FY12 Operating Plan

This is my 1000th blog post.  Readers have visited the geekdoctor blog over a million times.   The discipline of writing every day has helped me become a better communicator in my work and personal lives.    Thanks for being a part of it.

Today, I'm publishing the BIDMC FY12 Information Systems Operating plan which includes all the high priority projects I identified in my earlier post about preparing for a new CEO.    

In the Clinical Information Systems area there are numerous important goals, but five that deserve a more focused discussion:

ICD-10 - A challenging and expensive compliance project that must be done because 70% of the revenue cycle is at risk.  The scope of the project includes BIDMC, it's community hospital affiliate BIDH-Needham, the owned physician group APG, the academic affiliated group HMFP and the private physicians in BIDPO.    The likely budget - $5-10 million.   The likely safety, quality, efficiency improvements - none at all.   Many in the industry recognize ICD-10 as a colossal waste of time and effort.  I've tried very hard to communicate this broadly and will continue that effort in articles, lectures and personal meetings in Washington.

Clinical Documentation - although all the ambulatory areas and ICU areas of BIDMC have online documentation, progress notes in the wards are still written on paper.   In order to improve care coordination, decision support, and provide the granularity necessary for ICD-10 coding, we will work hard to create multi-disciplinary documentation in our ward areas.

Electronic Medication Administration Records - We're redesigning  medication management from the supply chain to the bedside.   We'll adopt innovative tools to automate the new idealized processes.

Healthcare Information Exchange - Accountable Care Organizations will require increased health information exchange analytics.   All the stakeholders in Massachusetts have worked together on an HIE plan that connects every provider, payer and patient.   Now we need to build it.

Analytics - Turning data into information, knowledge and wisdom will require a new generation of analytics.   We're building those now.

The Fiscal Systems area includes several important compliance goals such as 5010 and enhancements to our human resources management systems.

Knowledge services will continue curation of our electronic library resources.

Media Services will enhance our streaming and conference room infrastructure.

In the Infrastructure area, there are important 15 important themes:

Data Protection - Develop and implement a strategy for protecting BIDMC authentication credentials and sensitive data accessed from personally owned computers including mobile devices.

Patch Management - Improve patch management sufficiently to reduce vulnerabilities by 50 percent or more on I.S. managed systems.

Voice Mail System - Replace the current voice mail system that supports over 6,000 accounts with a more up-to-date, IP-based system without incurring extended disruption of service or loss of old content.

Clinical Systems Service Level - Implement high availability features using Cache ECP and Red Hat Enterprise Linux clustering technologies.  Increase service levels from 99.9 percent to 99.99 percent due to Cache or Linux related problems.

DR Data Network - Virtualize the distribution layer of the data network in the disaster recovery center to permit more flexible repositioning of assets without regard to VLAN assignment.

Life Cycle Management - Replace one-third of the approximately 120 data network access switches in the east and west campuses with more up-to-date and efficient devices.

Security Dashboard – Develop metrics that in combination provide a way to quantify the risk, by subnet, of devices attached to our data network.   Using this information, apply security measures that are tailored to the relative risk each subnet presents.

Vulnerability Assessments – Deploy a commercial Vulnerability scanner along with updated processes and procedures to enhance our ability to identify and remediate vulnerable systems network wide.

Windows 7 – Upgrade all kiosk/public managed workstations to Windows 7 to enhance the user experience, improve security, and take advantage of better management features.   Upgrade at least 50 percent of business builds to Windows 7 with the balance targeted for FY13.

SQLServer Enterprise Edition – Migrate two-thirds or more of the 32 data bases still using Standard Edition to Enterprise Edition.   EE provides higher availability, larger hardware, improved auditing, and other features.

Rights Management – Improve the utility of the Varonis rights management system to include surveillance of unusual access patterns that may indicate a security issue.

Exchange 2010 – Plan the upgrade and deployment from Exchange 2007 to Exchange 2010.

Internet Access – Develop and implement a strategy that reduces the exposure of BIDMC IT technical resources and sensitive data to Internet-based malware that strikes a workable balance between the security threat and business need for Internet access.

Service Level Monitoring – Extend the use of Nagios software monitoring to 75 percent or more of the data center assets to improve the reliability, granularity, and accuracy of system alerts.

Storage – Migrate all new image acquisition PACs to Atmos and begin conversion of all Centera assets to Atmos.

We'll do all of this within the FTE, operating budget (less than 2% of the BIDMC Operating budget) and capital budget assigned.

I look forward to a great year ahead and share with all of you the lessons learned along the way.


Ned said...

John - thanks for all your work on sending 1000 postings! I especially benefit from the management, personal, and technology blogs. Please keep it up.

Thomas said...

Great post. Just curious how, or if, the growing demand for Mobile solutions and applications fit into your strategy at BIDMC?

Camla said...

That was nice of you to thank us! You deserve a GREAT BIG THANKS for all the wonderful information and insight you give us. I consider it a privilege to read your blog.