Wednesday, February 24, 2016

The Pillars of the BIDMC IT Strategic Plan

Communicating the IT strategic plan is one of the primary responsibilities of a CIO.   Most importantly, the IT strategic plan should be seen as an enterprise wide activity and not just an IT centric exercise.  IT should be an enabler for the strategy of the business and every IT tactic should tie back to a high priority of the business.

In 2016, the BIDMC IT strategic plan has five pillars that align with quality, safety and efficiency imperatives (instead of Meaningful Use, ICD10, and the Affordable Care Act as was the case 2013-2015).   The pillars are:

1.  Inpatient documentation which integrates novel communication methods such as groupware and secure texting
2.  Crowdsourced mobile apps as an enabler for patient generated healthcare data
3.  Security
4.  Care Management Medical Records (our term for population health integrated into the EHR)
5.  A move to the cloud including interoperability of data, documents, and images

Here’s a bit more detail about why these are driving our work in 2016

Documentation - although many organizations have been at HIMSS Level 7 and had paperless inpatient medical wards, BIDMC has purposely waited for the technology to evolve so that we have better usability and ergonomics.   In 2016, we’ll be able to use the internet of things, natural language processing, cloud-based voice recognition,  social networking ideas, and mobile to create an entirely different documentation experience.    We’re partnering with an equipment vendor to provide our nurses with a single device that wirelessly transmits all vital signs and observations into the EHR as structured flowsheet data.   We’re engineered a novel approach to searching all medical record content for much easier navigation of previously written content.   Cloud based voice recognition will enable clinician voice input to the medical record from any device, at any location, for any document.   Groupware and secure texting will enable team communication with better workflow than email and reading charts.   Everything is optimized for mobile.    Sometimes it pays to be a laggard when the clinician experience depends upon waiting for the convergence of technology, regulation, and demand.

Mobile apps - today, 80% of all BIDMC publicly available content/portals is accessed by mobile devices.   The desktop is dead.    If we want to engage patients and families we must gather subjective (how do you feel), objective (what is your blood pressure), and care plan progress on mobile devices.   We’ve already launched BIDMC@Home to gather the objective data.   In 2016 we’ll be adding new functionality to share even more data between doctor and patient.

Security - I’ve written about the Cold War that is security and the fact that security is a process not a project, that will never be complete.    We must make security the foundation of every application we launch and every infrastructure we procure.

Care Management Medical Records - What is population health?   If you ask 10 clinicians, you’ll get 12 answers.    Our view is that care management requires identification of a cohort based on about 50 data elements (problems, meds, allergies, labs, demographics)  then inserting that cohort into a queue with a plan/to do list for the entire care team (doctors, nurses, social workers, pharmacists, physical therapists etc) to process.     We’ve created a generalizable framework for care management and in 2016 we’ll roll it out broadly.

Cloud hosted services - As I wrote two weeks ago, agility requires the use of cloud hosted services.    We’re partnering with many vendors - Amazon, Google, Dell, Meditech, and AthenaHealth to move core functionality to the cloud in a way that builds greater data liquidity/information sharing while also protecting privacy.

It’s hard to create an elevator speech for IT but if I told you that we’re putting usability and the clinician/patient needs first, instead of overly prescriptive regulations,  and using social networking, mobile  analytics, and cloud to create automation that meets the goals of the business, I hope you would stand and cheer.

The five pillars of BIDMC IT in 2016 are our best hope to bring joy back to the practice of medicine.


John moore said...

John, those are good pillars to build on but believe your greatest challenge will be care management. Extending care processes into the community of stakeholders to improve a patient's health journey while concurrently optimizing utilization is not for th feint of heart. Encouraged to see BIDMC take up the challenge, but would like to know more as to how.

Was also wondering how BIDMC is approaching the issue of variability in care delivered. Today, it seems that this can be all over the map and often physicians themselves do not realize they are outliers. How will you bring more visibility to this issue across your provider network?

Keep up the good work and trust all is good on the farm.

Medical Quack said...

I like the name Care Management Medical Records a lot better than population healthcare care, as ask an insurance company what that is versus a doctor and the definition changes again:) Good metnion too about "time" as we have operation perception deception out there again thinking there's magical pixie dust out there to digitize healthcare once again. It takes time to develop the programs and code as you well know, but we're back to what I called the Sebelius Syndrome with marketing and others out there not putting out the full picture on the element of "time" for development once again, and I guess everyone forgot about the "time" Healthcare.Gov needed for code:)