The upcoming presidential election has everyone spooked - what if Donald Trump is actually elected? What will the transition of administrations, regardless of who is elected mean to healthcare and existing healthcare IT regulations? Will our strategic plans and priorities need to change?
I’ve spoken to many people in government, industry and academia over the past month about the rapid pace of change stakeholders are feeling right now. Here are a few of their observations:
1. In the next year or two there will continue to be consolidation in the healthcare IT industry. Many smaller EHR companies will fold due to declining marketshare and some established incumbents with older technologies are likely to sell their healthcare IT businesses or reduce their scope.
2. Mergers and acquisitions will continue to accelerate, reducing the number of stand alone community hospitals and practices. The end result is that the market for software supporting midsize hospitals and small group practices is likely to shrink since ACOs/networks/healthcare systems will probably mandate a single centralized EHR solution for the enterprise.
3. Although the election may change the regulatory burden, many incumbent vendors will be spending the next year or two complying with certification demands, reducing their ability to innovate. It’s quite a conudrum. The market is demanding innovative solutions in the short term, but vendors cannot produce them because their development resources have been co-opted by regulatory demands. Thus, vendors may see a reduction in new sales, which will diminish their ability to hire new staff to meet the regulatory demands, putting them even further behind. It reminds of a classic unstable system - beer pong. The more you miss, the more you drink, the more you miss. The more regulation, the fewer new sales, the less ability to deal with regulation.
4. The capacity of hospitals to pay large sums for EHR implemention and operation will be reduced as margins shrink during the fee for service transition to value-based payment. Vendors will be pressured to offer cloud hosted subscription models with standard configurations that are less resource intensive. Customization will be less attractive than a good enough platform that is affordable and highly usable.
5. As I wrote about last week, innovation is likely to come from one of two areas - smaller/agile companies that are not yet overwhelmed with regulatory burden or companies on the edges of the healthcare IT industry such as Apple, Google, and Amazon. It’s hard to predict the winners. There was a flurry of small startups in 2014-2015, but in 2016 we’re seeing them close/sell/merge. The pace of new startups has slowed.
What kind of innovation do we need? I have a “top challenges” list that includes
*A master patient identifier for the country
*A provider directory for the country
*A consent registry/record locator service for the country
*A customer relationship management platform that supports care management
*A groupware communication tool for healthcare
*A set of security solutions that makes two factor authentication/endpoint encryption easier
*A mobile platform for patient/family engagement that provides usability and high value transactions to the consumer
*A telehealth/telemedicine platform that supports documentation/billing in the cloud
*An interoperability platform that leverages cloud technologies to seamlessly provide clinicians with the information they need when their need it
*An analytics platform that notifies/alerts clinicians when something needs to be done - providing wisdom, not just a flood of data
I’m increasingly on the lookout for organizations which will address these challenges during the uncertain 24 months ahead. The advantage of being at Beth Israel Deaconess is that I can draw on all sectors - payers, providers, patients, established industry and startups to aquire potential solutions. Situational awareness and agility are a must for the months ahead. I’m keeping my running shoes on!
Wednesday, June 8, 2016
Thursday, June 2, 2016
Unity Farm Journal - First Week of June 2016
My daughter's post wedding bliss was followed by the newlyweds move out of Tufts (Medford, MA) and a move into a new apartment in Brookline, MA. My son in law will be attending graduate school in the Longwood Medical Area.
Over the past few years, I’ve worked on many moves - parental moves, our own moves, and now my daughter’s move. At this point, everyone in the family is ideally situated for the next phase of life. I can only hope we’ll have a decade without any more moves!
We’ve had a very unusual May with high heat and high humidity. That caused the lettuce in the hoop house to bolt so we’ve harvested all the Boston, Bibb, and Romaine lettuce, replacing it with peppers, tomatoes, cucumbers, basil and eggplant. We’ve increased irrigation and kept the hoop house sides maximally opened. Even the geese are using our water features as drinking foundations.
We have our final inspection for organic certification next week. Once that is done, we’ll be able to use “USDA organic” label on all our products.
We’re starting two new businesses on the farm that will enhance our profitability. We generate about 10,000 pounds of finished alpaca compost every year. We’ve found a local market for organic compost and will be using the product name “Unity Farm Llama Beans”. I built a compost screener and we've purchased one cubic foot poly bags so that we can cleanly package our aged/fully mature compost. The only ingredients are timothy hay and alpaca/llama droppings, all aged 2 years after 140F composting and monthly turning. Who knew you could turn poop into gold?
We’re also selling organic seedlings to our local farm stand, Tilly and Salvys in Natck. You’ll find cucumbers (slicing and pickling), tomatoes, and eggplant seedlings from Unity Farm ready to plan in peat pots. This weekend, we’ll deliver 50 basil seedlngs, ready to plant.
Over the weekend, we’ll harvest Shitake mushrooms,lettuce, kale, and eggs.
It feels like Summer, but in just a few weeks, we'll start our Fall seedlings. A farmer never rests.
Over the past few years, I’ve worked on many moves - parental moves, our own moves, and now my daughter’s move. At this point, everyone in the family is ideally situated for the next phase of life. I can only hope we’ll have a decade without any more moves!
We’ve had a very unusual May with high heat and high humidity. That caused the lettuce in the hoop house to bolt so we’ve harvested all the Boston, Bibb, and Romaine lettuce, replacing it with peppers, tomatoes, cucumbers, basil and eggplant. We’ve increased irrigation and kept the hoop house sides maximally opened. Even the geese are using our water features as drinking foundations.
We have our final inspection for organic certification next week. Once that is done, we’ll be able to use “USDA organic” label on all our products.
We’re starting two new businesses on the farm that will enhance our profitability. We generate about 10,000 pounds of finished alpaca compost every year. We’ve found a local market for organic compost and will be using the product name “Unity Farm Llama Beans”. I built a compost screener and we've purchased one cubic foot poly bags so that we can cleanly package our aged/fully mature compost. The only ingredients are timothy hay and alpaca/llama droppings, all aged 2 years after 140F composting and monthly turning. Who knew you could turn poop into gold?
We’re also selling organic seedlings to our local farm stand, Tilly and Salvys in Natck. You’ll find cucumbers (slicing and pickling), tomatoes, and eggplant seedlings from Unity Farm ready to plan in peat pots. This weekend, we’ll deliver 50 basil seedlngs, ready to plant.
Over the weekend, we’ll harvest Shitake mushrooms,lettuce, kale, and eggs.
It feels like Summer, but in just a few weeks, we'll start our Fall seedlings. A farmer never rests.
Wednesday, June 1, 2016
Making a Difference
When my father died 3 years ago, my comments at his funeral noted that the greatest aspiration any of us can have is to make a difference in the world. My father’s life made a difference.
I’m always self critical and analyzing my own life. I moved to Boston 20 years ago this month. In those 20 years of service to BIDMC, Harvard, numerous federal organizations, international governments, and industry, I’m hopeful that I’ve laid a foundation for 20 more years of trying to make a difference. It’s hard to forecast the best path to have an impact on the healthcare ecosystem, but I can try.
The past 5 years belonged to government - with $34 billion spent on healthcare IT as a result of HITECH, the Meaningful Use program accomplished the goal of moving clinician practices and hospitals from paper to digital systems. Although many challenges remain - improving workflow, enhancing quality/safety, and ensuring usability, the basic platform on which we can build future innovation has been created.
The govenrment will conintue to be very a important actor, especially CMS, setting payment policy that will impact the behavior of all stakeholders. However, I believe the era of prescriptive government direction of the IT agenda has ended. Provider organizations are begging for an outcomes focus, instead of a process focus.
Where will the next innovations come from?
How about the large incumbent HIT vendors? Despite rumors to the contrary our major healthcare IT vendors are well meaning and not spending their time information blocking. They are devoting their resources to creating software which adheres to the thousands of pages of regulations introduced over the past few years. One major vendor noted that their programming staff is already booked for the next 32 months just to ensure compliance with existing regulations. The small amount of free bandwidth that incumbent vendors had reserved for innovation has been co-opted by regulation.
How about startups or high tech companies that have a startup mindset? Startups, such as those making population health/care management, decision support, and consumer facing apps likely have more time to focus on innovation than incumbent EHR vendors maintaining certified EHRs. Many of these startups lack domain expertise in heatlhcare processes, so they may not produce the products and services the marketplace really needs. However, that’s ok, since out of many failures often comes one great success. I think we need to watch companies like Apple, Google, Amazon, Facebook, and Salesforce for important healthcare innovations.
How about provider organizations? Some academic healthcare systems have dedicated innovation resources and they will continue to lead important work. However, provider organizations are faced with the compliance/enforcement side of the same regulatory expansion that is consuming the incumbent vendors. Most provider organizations will devote 100% of their IT resources to operations and compliance.
So, it’s an edgy prediction, but I beleive the next 5 years of healthcare IT innovation will belong to the private sector, to companies we’ve not yet heard of and companies outside the usual healthcare IT mainstream. The incumbent vendors may be able to crowdsource and leverage the resources of these innovators, as Athena will do with the More Disruption Please program and Epic will do with its app store.
At BIDMC, we’ve launched our own crowdsourcing program and we’re increasingly dedicating resources to innovation. We’ll continue our collaboration with numerous private sector companies, serving as a learning lab to test new ideas.
In my next 20 years, I hope to oversee innovative work on social networking communication applications, patient-facing mobile applications, population health analytics with workflow tools, and cloud-based healthcare IT services. I turned 54 this month. I’m hoping at 74 that I can reflect on 40 years in New England and say that my efforts have made a difference.
Thursday, May 26, 2016
Unity Farm Journal - Fourth Week of May 2016
What is the definition of the perfect wedding? Joy, love, happiness, inspriration and energy are felt by everyone? Families come together without conflict, embarrasment, or awkwardness? The guinea fowl avoid flying over the guests?
If that’s the definition, my daugther’s wedding at Unity Farm this weekend was a 10 out of 10.
Here are two photos
My daughter Lara and my son in law David designed the ceremony, wrote the vows, and created an afternoon at the farm in which all the guests told stories about their lives with the bride and groom. We had 18 guests total - just family and close friends.
We drank Unity Farm beverages, ate Unity Farm foods, and gave farm tours - the tree houses, the pigs, the vegetables, the trails, and the revolutionary war era graves. We even picked "marriage carrots".
I’ll post a digital album of the festivities soon.
Although the wedding prep, events, and cleanup consumed our weekend, we still were able to deliver vegetables to the Tilly and Salvy’s farm stand. Here’s my notebook entry
1 case Farmhouse cider
2 dozen eggs
1.5 pounds of Shiitake mushrooms
6 heads of Romaine
24 Atomic purple carrots
1 pound kale
1 pound mache
6 heads of Bibb lettuce
We’re truly a small family farm delivering items picked by hand and grown with care. This weekend, we’re running a mushroom mini-course. We may offer educational seminars on weekends in the future. We’ll continue our summer planting - marketmore cucumbers, purple bell peppers, and bellstar tomatoes. The berries are all in flower and the farm is burst of green everywhere - we’re at the peak of Spring growth, which provided the perfect setting for a relaxed wedding.
If that’s the definition, my daugther’s wedding at Unity Farm this weekend was a 10 out of 10.
Here are two photos
My daughter Lara and my son in law David designed the ceremony, wrote the vows, and created an afternoon at the farm in which all the guests told stories about their lives with the bride and groom. We had 18 guests total - just family and close friends.
We drank Unity Farm beverages, ate Unity Farm foods, and gave farm tours - the tree houses, the pigs, the vegetables, the trails, and the revolutionary war era graves. We even picked "marriage carrots".
I’ll post a digital album of the festivities soon.
Although the wedding prep, events, and cleanup consumed our weekend, we still were able to deliver vegetables to the Tilly and Salvy’s farm stand. Here’s my notebook entry
1 case Farmhouse cider
2 dozen eggs
1.5 pounds of Shiitake mushrooms
6 heads of Romaine
24 Atomic purple carrots
1 pound kale
1 pound mache
6 heads of Bibb lettuce
We’re truly a small family farm delivering items picked by hand and grown with care. This weekend, we’re running a mushroom mini-course. We may offer educational seminars on weekends in the future. We’ll continue our summer planting - marketmore cucumbers, purple bell peppers, and bellstar tomatoes. The berries are all in flower and the farm is burst of green everywhere - we’re at the peak of Spring growth, which provided the perfect setting for a relaxed wedding.
Wednesday, May 25, 2016
A Zero Tolerance Policy for Business Spam
In 2011 and 2012 I wrote about the increasing problem of Business Spam - unsolicited, unconsented advertising that has grown in volume to the point that it constitutes more than half of my email . In 2016, I’ve done an experiment - I’ve not opted in to any newsletter, any website offering notifications or any vendor offering information. I’ve monitored my mailbox for violators of good email practices.
This month, we put a stop to it - cold turkey. Anyone sending business spam is now blocked from the 22,000 users of Beth Israel Deaconess and its affiliates.
Here’s how we did it - using a commercially available appliance we have black listed organizations which send bulk email and companies which violate unsolicitied email policies.
I realize there are many categories of activity going on here
1. Those who have my contact information for a legitimate business reason but sell that information without my consent. Maybe there is something buried in a conference registration that suggests my information will be sold, but I’ve never found such a disclosure.
2. Those who create mailing lists by guessing at email addresses. John.halamka, halamkaj, john_halamka, halamka.john are all guesses since I’ve never used such addresses on any materials.
3. Those who facilitate bulk mailing. I’ve had conversations with the management of companies that provide bulk mailing services such as newsletters/product updates/special deals. Many of these bulk mailing companies have sound anti-spam policies. However, they have to trust that organizations which use their services adhere to the policies, accepting attestation that consent/subscription has been obtained from receipients on mailing lists. Many customers of bulk mailing outfits submit false attestations. Remember, I’ve not opted into a single thing in 2016 and I’m receiving hundreds of bulk emails every day.
May of 2016 marks “email liberation” month at BIDMC, since we put a stop to the electronic equivalent of garbage passing through our email gateways. This Zero tolerance for bulk email approach may very well transform email into a once again useful medium for communication. Sure, we’ll implement secure texting and groupware over the next year as alternatives to email, but there is a chance email could be salvaged.
My email box has gone from 1500 emails a day to 150. If everyone does this, maybe the business spammers will stop their flood of unwanted communications.
Viva the email liberation!
This month, we put a stop to it - cold turkey. Anyone sending business spam is now blocked from the 22,000 users of Beth Israel Deaconess and its affiliates.
Here’s how we did it - using a commercially available appliance we have black listed organizations which send bulk email and companies which violate unsolicitied email policies.
I realize there are many categories of activity going on here
1. Those who have my contact information for a legitimate business reason but sell that information without my consent. Maybe there is something buried in a conference registration that suggests my information will be sold, but I’ve never found such a disclosure.
2. Those who create mailing lists by guessing at email addresses. John.halamka, halamkaj, john_halamka, halamka.john are all guesses since I’ve never used such addresses on any materials.
3. Those who facilitate bulk mailing. I’ve had conversations with the management of companies that provide bulk mailing services such as newsletters/product updates/special deals. Many of these bulk mailing companies have sound anti-spam policies. However, they have to trust that organizations which use their services adhere to the policies, accepting attestation that consent/subscription has been obtained from receipients on mailing lists. Many customers of bulk mailing outfits submit false attestations. Remember, I’ve not opted into a single thing in 2016 and I’m receiving hundreds of bulk emails every day.
May of 2016 marks “email liberation” month at BIDMC, since we put a stop to the electronic equivalent of garbage passing through our email gateways. This Zero tolerance for bulk email approach may very well transform email into a once again useful medium for communication. Sure, we’ll implement secure texting and groupware over the next year as alternatives to email, but there is a chance email could be salvaged.
My email box has gone from 1500 emails a day to 150. If everyone does this, maybe the business spammers will stop their flood of unwanted communications.
Viva the email liberation!
Friday, May 20, 2016
A Multi-Stakeholder Discussion in Washington
On Thursday, I spent the day in Washington with a group of government, provider, and developer sttakeholders convened by the Institute of Healthcare Improvement. We operated under Chatham House Rules, so I can summarize the discussion but not identify any of the participants or their specific statements. Below are three questions we discussed and the observations we made:
1. What worked in CMS and ONC rules (HIT related regulations)?
*Meaningful Use provided a foundation of basic electronic record functionality
*We enhanced systemness thinking and created learning groups to address vulnerabilities in discconnected systems
*We made safety improvements and enabled analytics
*We enhanced patient engagement and dispelled several myths
*We automated quality measurement processes and recorded social determinants of healthcare
*We encouraged EHR optimization
*We enhanced Interoperability for public health transactions, eprescribing and entry of vocabulary controlled data (problems/meds/allergies/labs)
*We incentivized new entrants into the marketplace
*We enabled standardization of workflows
*We found that CMS was a good listener
*We began to engage post acute providers
*We caused infrastructure to be upgraded (to support EHR implementation)
*We enabled remote access to records
*We created an ecosystem for home care devices and wearables to become relevant
*We taught stakeholders that clinical automation is not an IT project
*We began to focus on the user experience
2. What didn’t work or could have been done better?
*Products were rushed to market and they were not as usable or as intuitive as we’d like
*We did not achieve a consensus on national priorities - where we want electronic records to be in 5 years
*We did not include behaviorial health providers
*We did not enable team communication
*We did not enable substitutable apps that can be shared across vendors
*We required too much non-valued data entry
*We often digitized the paper world
*We ended up with regulatory complexity
*We required too many clicks, causing a loss of patient focus
*Once the foundation was laid we did not have time to digest the changes, interatively improve and innovate
*Certification consumed too many development resources
*We hired scribes as a workaround to overwhelming data entry requirements
*We required documentation to satisfy legal and regulatory concerns rather than patient care needs
*We demanded Interoperability without first building enabling infrastructure
*IT service levels did not always align with clinical requirements
*We underestimated the burden of the impact of HITECH on providers and developers
*We made patient engagement too hard
*We did not turn data into information, knowledge and wisdom
*We focused on compliance instead of joy in the workplace (or joy for the patients)
*We did not enable the marketplace to meet customer demands
*We focused on billing rather than clinical workflow
*We tried to do too much, too soon
3. How do we shape the future based on lessons learned?
*IHI Leadership Alliance/EHR workgroup should submit a comment letter about MACRA/MIPS to CMS
*Reconciling the tension among Developers, Government , Providers, Patients will required argreement about who is the user/customer, what is success, what is considered a good outcome
*Instead of just Interoperability we need to think about the functionality needed for a collaborative work and a more uniform user experience
*We need to build Infrastructure enablers - a catalog of constrained standards, a national patient identifer (or private sector solution i.e. CHIMEchallenge/Commonwell/Surescripts/CareEverywhere), a national provider directory, a trust fabric, uniform consent policies among states
*We need to align economic incentives among stakeholders
*We need to consider the impact of the emerging consumer driven digital ecosystem
*We need to recognize that the EHR is not the center of the universe and enable other tools such as EHR agnostic warehouse solutions
*We need liquidity of claims data
*Documentation/coding rules need to enable team-based care by all clinicians
*We need education to dispel fear of HIPAA and enable a culture of sharing
1. What worked in CMS and ONC rules (HIT related regulations)?
*Meaningful Use provided a foundation of basic electronic record functionality
*We enhanced systemness thinking and created learning groups to address vulnerabilities in discconnected systems
*We made safety improvements and enabled analytics
*We enhanced patient engagement and dispelled several myths
*We automated quality measurement processes and recorded social determinants of healthcare
*We encouraged EHR optimization
*We enhanced Interoperability for public health transactions, eprescribing and entry of vocabulary controlled data (problems/meds/allergies/labs)
*We incentivized new entrants into the marketplace
*We enabled standardization of workflows
*We found that CMS was a good listener
*We began to engage post acute providers
*We caused infrastructure to be upgraded (to support EHR implementation)
*We enabled remote access to records
*We created an ecosystem for home care devices and wearables to become relevant
*We taught stakeholders that clinical automation is not an IT project
*We began to focus on the user experience
2. What didn’t work or could have been done better?
*Products were rushed to market and they were not as usable or as intuitive as we’d like
*We did not achieve a consensus on national priorities - where we want electronic records to be in 5 years
*We did not include behaviorial health providers
*We did not enable team communication
*We did not enable substitutable apps that can be shared across vendors
*We required too much non-valued data entry
*We often digitized the paper world
*We ended up with regulatory complexity
*We required too many clicks, causing a loss of patient focus
*Once the foundation was laid we did not have time to digest the changes, interatively improve and innovate
*Certification consumed too many development resources
*We hired scribes as a workaround to overwhelming data entry requirements
*We required documentation to satisfy legal and regulatory concerns rather than patient care needs
*We demanded Interoperability without first building enabling infrastructure
*IT service levels did not always align with clinical requirements
*We underestimated the burden of the impact of HITECH on providers and developers
*We made patient engagement too hard
*We did not turn data into information, knowledge and wisdom
*We focused on compliance instead of joy in the workplace (or joy for the patients)
*We did not enable the marketplace to meet customer demands
*We focused on billing rather than clinical workflow
*We tried to do too much, too soon
3. How do we shape the future based on lessons learned?
*IHI Leadership Alliance/EHR workgroup should submit a comment letter about MACRA/MIPS to CMS
*Reconciling the tension among Developers, Government , Providers, Patients will required argreement about who is the user/customer, what is success, what is considered a good outcome
*Instead of just Interoperability we need to think about the functionality needed for a collaborative work and a more uniform user experience
*We need to build Infrastructure enablers - a catalog of constrained standards, a national patient identifer (or private sector solution i.e. CHIMEchallenge/Commonwell/Surescripts/CareEverywhere), a national provider directory, a trust fabric, uniform consent policies among states
*We need to align economic incentives among stakeholders
*We need to consider the impact of the emerging consumer driven digital ecosystem
*We need to recognize that the EHR is not the center of the universe and enable other tools such as EHR agnostic warehouse solutions
*We need liquidity of claims data
*Documentation/coding rules need to enable team-based care by all clinicians
*We need education to dispel fear of HIPAA and enable a culture of sharing
Thursday, May 19, 2016
Unity Farm Journal - Third Week of May 2016
Wedding plans have occupied much of this week at Unity Farm, ensuring that my daughter’s marriage weekend has perfect logistics. A wedding on a farm is more challenging than you think - how do you prevent flying guinea fowl from leaving “gifts” on the guests? Should the pigs be moved to minimimze squealing during the ceremony? How do you prevent chickens from eating the flowers? We’ll be serving Unity Farm foods and beverages, accompanied by vegan/vegetarian catering. The family begins arriving tonight.
This week, another goose, Hermes, was born. Our weather has been very unusual and we’ve had a series of nights with temperatures in the 30’s. Hermes was wet and chilled while hatching and became hypothermic. We warmed and dried him in the incubator then placed him in the brooder. He was so weak that he could not stand/walk and had splayed legs
We’ve treated splayed legs in guinea fowl before so we knew how to make a brace, keeping the femurs aligned so that the hip joints would not develop laxity. It’s critical to intervene on the first day of life, otherwise the bird will never walk. With the brace in place, fresh food/water, and physical therapy every few hours, Hermes gathered strength and today he is walking. We’ll return him to the goose house today or tomorrow. We named him Hermes because we knew he’d heal and become a swift runner through the barnyard.
The transition from winter crops to summer crops continues with tomatoes, peppers, eggplant now filling beds that held lettuce, spinach, kale, chard, and carrots. We built a 16x16 foot raised squash bed outside the hoop house, which gives our kabocha (Japanese pumpkins) plenty of room to spread.
Now that we have so much produce production, we’ve had to improve the efficiency of our harvest and packing operation. We built a wash stand so that vegetables go from raised bed, to washing, to packaging, to farm stands in minutes. On Sunday morning, before anyone in the wedding party is even awake, we’ll be delivering lettuce to Tilly and Salvy’s.
In between wedding planning and project work, Kathy has been hard at work on bee hives this week. It’s the time of year when bees tend to expand their territory and she’s been called all over the Metrowest area to capture swarms. Unity Farm is the temporary home to many new colonies this week since Kathy has been climbing ladders, cutting swarm covered branches and placing them in “nuc” boxes. She’ll be creating more hives and spreading the bees among the many hive hosting locations she’s now managing. We’ll likely end up with 25 hives by the end of the season.
I’m in Washington today, attempting to constrain healthcare IT regulatory zeal. Tomorrow is a day off to finish all the wedding details. Pictures to follow next week
This week, another goose, Hermes, was born. Our weather has been very unusual and we’ve had a series of nights with temperatures in the 30’s. Hermes was wet and chilled while hatching and became hypothermic. We warmed and dried him in the incubator then placed him in the brooder. He was so weak that he could not stand/walk and had splayed legs
We’ve treated splayed legs in guinea fowl before so we knew how to make a brace, keeping the femurs aligned so that the hip joints would not develop laxity. It’s critical to intervene on the first day of life, otherwise the bird will never walk. With the brace in place, fresh food/water, and physical therapy every few hours, Hermes gathered strength and today he is walking. We’ll return him to the goose house today or tomorrow. We named him Hermes because we knew he’d heal and become a swift runner through the barnyard.
The transition from winter crops to summer crops continues with tomatoes, peppers, eggplant now filling beds that held lettuce, spinach, kale, chard, and carrots. We built a 16x16 foot raised squash bed outside the hoop house, which gives our kabocha (Japanese pumpkins) plenty of room to spread.
Now that we have so much produce production, we’ve had to improve the efficiency of our harvest and packing operation. We built a wash stand so that vegetables go from raised bed, to washing, to packaging, to farm stands in minutes. On Sunday morning, before anyone in the wedding party is even awake, we’ll be delivering lettuce to Tilly and Salvy’s.
In between wedding planning and project work, Kathy has been hard at work on bee hives this week. It’s the time of year when bees tend to expand their territory and she’s been called all over the Metrowest area to capture swarms. Unity Farm is the temporary home to many new colonies this week since Kathy has been climbing ladders, cutting swarm covered branches and placing them in “nuc” boxes. She’ll be creating more hives and spreading the bees among the many hive hosting locations she’s now managing. We’ll likely end up with 25 hives by the end of the season.
I’m in Washington today, attempting to constrain healthcare IT regulatory zeal. Tomorrow is a day off to finish all the wedding details. Pictures to follow next week
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