Wednesday, March 6, 2013

My Top Healthcare IT Concerns for 2013

It's HIMSS week and IT professionals are gathering in New Orleans to find the products and services that solve their application and infrastructure problems.

What are my top healthcare IT concerns during HIMSS week 2013?

1.  Achieving Meaningful Use Stage 2 - at BIDMC we've already exceeded the hospital thresholds for the core and menu set measures of MU Stage 2 per this dashboard, except for electronic medication administration records/bedside medication verification, which we're implementing now per this project plan.    To attest this Fall, we'll need to complete self certification of our application suite (we build and buy so our approach to certification is to use CCHIT's EHR Alternative Certification for Healthcare Providers "EACH" program for all our enterprise applications.)   Once we complete hospital and eligible professional certification, we'll ensure all our stakeholders are educated about the changes we've made in functionality and workflow.    We're on target for an October 1,2013-December 31,2013 reporting period and we have no dependency on vendors since we've created the key software ourselves.

2.  Implementing ICD-10 including clinical documentation improvement - per yesterday's blog the entire organization is focused on several work streams - Technology, Payer/Contracting, Workflow/Computer assisted coding, Education/Clinical documentation improvement - that are needed to make the ICD-10 project successful.   It's not enough just to retrofit systems to capture longer/more complex codes.  The entire approach to documentation and billing must be changed to ensure sufficient detail is captured to justify the codes selected.

3.  Supporting ACO Needs - When I ask stakeholders what they need to be successful in managing Pioneer ACO global capitated risk contracts, they tell me they need an omnibus care coordination and analytic platform that consolidates data from all sites of care during the patient's lifetime to enable care management and real time decision support.    Basically it's HIE plus analytics, but no one knows exactly how it should work and few mature products are available in the marketplace to meet these needs.  Hence the reason, we'll need to build the Care Management Medical Record.

4.  Fulfilling all compliance/regulatory requirements including the new HIPAA rule - In a world of more mobile devices (BYOD), cloud computing, and increased HIPAA enforcement, it's challenging to share more data with more people for more purposes while at the same time keeping it secure.  We have 14 work streams to enhance our security maturity including many enhancements that will go live over the next 90 days.

5.  Managing levels of employee stress - implementing Meaningful Use Stage 2, ICD10, Accountable Care, Compliance requirements, and keeping the operational trains running  day to day puts enormous stress on staff at all levels.   Balancing the scope of projects, the resources required, and the timing which keeps staff excited but not overwhelmed requires continuous course correction.  Try finding that product at HIMSS!


Anonymous said...

I still don't understand why you don't support other computer networks. Or at least mention the smallest chance of a less annoying computer. "ONLY BILL GATES APPROVED PROGRAMS". Especially in the field of medicine.

Medical Quack said...

My latest "coin"...the short order code kitchen burned down a few years ago and there was no fire sale"...I think the light bulbs of reality are finally sinking in with today's complexities and having every area working correctly with minimal errors..

I miss the old days too when you started with nothing and had something you created that lead way to efficiencies, savings, you name it..and it was silo'd...but not where we are at today...and silos are gone forever.

Now with data aggregation we are still doing that but it's no longer from scratch and the complexities are here to stay.

I don't think those who make laws in the US are fully cognizant of how just in a few short years how all of this has changed, and thus so I think the Sunshine Foundation makes a good point over re-establishing the Office of Technology at leas they get exposed to some of what happening out there. Anything is better than nothing:)

Unknown said...

John, I applaud your focus on employee stress. As long as incentives (and stress) are focused only on those who address supply and not those who create demand, the stress will remain. I marvel at the number of small "asks" that have a cumulative impact on workforce time demands. Each individual's ask may be relatively small, but my hypothesis is that when summed, the impact on productivity is significant. If those asking were part of the incentive structure for organizational goals, I would suspect that the demand would drop. Your thoughts?

Unknown said...

I never really put much thought into employee stress. During my echocardiography training I had more thought on making sure the patient was comfortable, even if I wasn't. Now I'm going to be reflecting on that while I'm at work...

Anonymous said...


I've been reading your blog off and on for the past few years and have always appreciated your insights.

I'd like to talk with you about what we're doing along in support of your item number 4 around ACO support and building out your CMMR.

With the Utah Health Information Network (UHIN), HealthInsight, and the Utah DOH, we demo'ed at the ONC's Interoperability Showcase, some of the key pieces you're referencing around an "HIE plus Analytics"

We work with HIE's and other similar groups to bring together disparate data types (ADT data, MPI, Patient Consent Indexes, Labs, Radiology notes, Transcriptions, Claims data, etc.) to be then used for reporting, research, analytics, and even decision support.

The idea is to be able to show people that not only is this work possible, and meaningful, but using existing technologies, it's also economical.

I would really encourage you to take a look at what it is that we're doing. I believe that it would be the gateway to making your CMMR project an economically viable reality.