I recently had the privilege of participating in the Health Information Technology Expert Panel (HITEP) of the National Quality Forum (NQF), part of a joint effort of many stakeholders to rethink the way quality is measured from data in Electronic Health Records and Hospital Information Systems.
This week, the draft report will describe an analysis of data types commonly used in quality measures, as part of the quality metric "harmonization" process to be implemented by HITSP, NQF, AMA/NCQA and the Quality Metric authoring organizations (Joint Commission, AQA, HQA etc.)
The idea is simple. In the past, quality metric authors have produced carefully specified, evidence-based quality measures. The challenge is that these carefully designed indicators are not computable from existing hospital information systems and ambulatory care records. There are so many exclusions in the measurements that manual chart abstraction, an expensive and time consuming approach, is the only way to collect data for these measurements.
For example, excluding all patients on “comfort measures only” from quality measures creates a very accurate denominator, but no hospital information system in production today uses the SNOMED vocabulary term for “comfort measures only” in the electronic patient record. This begs the question - if this exclusion were eliminated would it really matter? If we assume that “comfort measures only” is a reasonably evenly distributed event at all hospitals in the country, then the metrics will be very slightly off for every hospital. Similarly, exclusing women with a history of polycystic ovarian syndrome from diabetic measures can be challenging. Assuming polycystic disease is evenly distributed in the country, why use this exclusionary criteria?
With the idea that we should create the best quality measures possible given the data we can gather electronically, here's the new process. As part of the NQF-endorsement process, Quality measure developers will submit their proposed measures to the NQF. The NQF will analyze the data types needed to complete the measures (i.e. labs, medications, problems, allergies, demographics) and forward a request for standards harmonization to HITSP. HITSP will recommend the standards for each of these data types and will report on gaps. Further, HITSP and NQF will work together to report on data quality/adoption - even with good standards, how much of the data is available today with reasonably good data integrity. Based on the analysis of data types, standards readiness, and data avalability analysis, NQF will offer feedback to the quality measure developers to refine the measures to ensure they are computable.
With easily calculated quality metrics, hospitals and ambulatory care facilities can deploy real time dashboards and decision support to offer clinicians the just-in-time information they need to improve quality. Compare that to manual chart abstraction which takes months and $20/chart in labor.
As a first step, NQF and HITSP have worked through 84 NQF-endorsed AQA/HQA measures that exist for the IOM Priority Areas listed below:
1. Asthma
2. Cancer screening
3. Care coordination
4. Diabetes
5. End-of-life with advanced organ system failure
6. Frailty associated with old age
7. Immunization
8. Ischemic heart disease
9. Major depression
10. Medication management
11. Pregnancy and childbirth
12. Stroke
13. Tobacco dependence treatment in adults
and derived 35 data types requiring standards. The HITSP Population Health Technical Committee will deliver the harmonized standards for these data types on December 13, 2007 at the HITSP Panel meeting in Washington.
Working together, NQF/HITEP, HITSP, AMA/NCQA, and the quality metric authoring organizations are well along the way to producing computable quality measures for the country. As these are implemented in hospitals and ambulatory care centers in 2008-2009, the burden of data collection will be reduced and the amount of actionable knowledge (see my previous blog entry here) about the care we deliver will markedly increase.
Sunday, November 25, 2007
Wednesday, November 21, 2007
Cool technology of the week
Last week I started a Cool Technology post which I intend to do every Friday.
As part of my flexible work arrangement research, I've been testing video conferencing technologies. The coolest technology is Cisco's Telepresence infrastructure. John Chambers demonstrates it here
I've tested H323 software and hardware, Video IM chat, and iChat via Jabber. The big question raised by all of these technologies is best described in this email sent to me by Paul Gray, Professor Emeritus of Information Science, Claremont Graduate University:
"Being retired, I receive my copies of Computerworld in batches from my office. Hence I only now read your September 15 article on flexible schedules. I was pleased to see that you found the need for initial meetings important in your thinking. I thought you would like to know that this concept is not a new idea. When we first proposed telecommuting (Telecommuting-Transportation Tradeoffs: Options for Tomorrow, Wiley 1975) we quoted results that we found in the literature on the dispersal of government workers out of central London and central Stockholm in the 1960s. The dispersal was the result of, for example in London, of the concentration of office jobs that wound up depopulating the hinterlands of young people. Everybody complained that they could not be moved out because they needed continual face to face contact with people in other agencies. Studies were done that found that once there is an initial meeting, which coupled a human face and body language with voice and correspondence, people were able to work in dispersed mode with no loss of effectiveness. However, they did need periodic (typically 6 month) refreshing of the initial contact so that the ties would be maintained"
It may turn out that audio via phone, combined with desktop sharing/whiteboards/IM will be good enough without video. My full report will be complete in January.
As part of my flexible work arrangement research, I've been testing video conferencing technologies. The coolest technology is Cisco's Telepresence infrastructure. John Chambers demonstrates it here
I've tested H323 software and hardware, Video IM chat, and iChat via Jabber. The big question raised by all of these technologies is best described in this email sent to me by Paul Gray, Professor Emeritus of Information Science, Claremont Graduate University:
"Being retired, I receive my copies of Computerworld in batches from my office. Hence I only now read your September 15 article on flexible schedules. I was pleased to see that you found the need for initial meetings important in your thinking. I thought you would like to know that this concept is not a new idea. When we first proposed telecommuting (Telecommuting-Transportation Tradeoffs: Options for Tomorrow, Wiley 1975) we quoted results that we found in the literature on the dispersal of government workers out of central London and central Stockholm in the 1960s. The dispersal was the result of, for example in London, of the concentration of office jobs that wound up depopulating the hinterlands of young people. Everybody complained that they could not be moved out because they needed continual face to face contact with people in other agencies. Studies were done that found that once there is an initial meeting, which coupled a human face and body language with voice and correspondence, people were able to work in dispersed mode with no loss of effectiveness. However, they did need periodic (typically 6 month) refreshing of the initial contact so that the ties would be maintained"
It may turn out that audio via phone, combined with desktop sharing/whiteboards/IM will be good enough without video. My full report will be complete in January.
A Vegan Thanksgiving
People have asked me what a vegan eats for Thanksgiving. Today's menu includes
Salad: Warm heirloom beet, carrot and edamame salad - a simple mixture of freshly boiled vegetables placed on a bed of baby greens and drizzled in balsamic vinegar
Protein: Tofurky - a tofu and grain-based roast available from Turtle Island Foods . I do not typically eat meat substitutes since I enjoy the inherent food qualities of tofu, tempeh and seitan, but a Tofurky is great for family holiday entertaining.
Sides:
Harvest vegetable medley -brussell sprouts, butternut squash, cauliflower, fingerling potatoes, leeks, carrots, parsnips, garlic, bell pepper and fresh herbs roasted at 450F
Red lentils - simmered in vegan low-sodium bullion and flavored with cumin
Fresh roasted chestnuts
Mashed yukon gold potatoes (no butter or cream added, just a bit of soy milk)
Wines: Louis Roederer non-vintage Champagne, Chassagne Montrachet Maltroye 2001
Dessert: Vegan cranberry apple pie, Gyokuro Asahi green tea
I really look forward to those fresh Tofurky sandwiches after Thanksgiving!
Although the focus of this blog is IT, here's a brief personal word about my own vegan experience. In the 1990's I had a body mass index of 30 (that's obese) . I lived the all stress diet of a CIO: Starbucks grande lattes, supersized fast food, and business meals at the local steakhouse. I kept a bottle of Tums and Motrin on my desk. In 2000, I visited my primary care physician for the first time in a decade and discovered that my HDL cholesterol was low, LDL cholesterol was high, and blood pressure was borderline hypertensive (140/90).
I was offered the possibility of Lipitor, Ace Inhibitors, Beta Blockers, Nexium etc. Instead I changed my lifestyle. I first eliminated caffeine. Other than two weeks of headaches, sweats, irritability, tremulousness, insomnia, and fatigue, it was no problem. Without caffeine, I no longer craved the afternoon Krispy Kreme and all gastric reflux symptoms disappeared. My emotions and blood glucose became stable 24 hours a day. I no longer craved morning coffee and slept naturally instead of waking to caffeine withdrawl.
I then stopped eating fast food, fried foods, and beef. From there, I ate only chicken and fish. Then, I eliminated all meats and fish. As my 14 year old daughter would say, "I no longer ate anything with a mother". From there, I eliminated all animal products - no dairy and no eggs. I ate tofu, fresh vegetables, rice, and legumes, losing 65 pounds (before and after). That was 5 years ago and the drop in weight has enabled me to become more active. Today, I do not miss animal products. However, when I travel (especially in Eastern Europe) being vegan is challenging, so I may have vegetarian meals that include eggs or dairy. The end result of my years as a vegan is the data from my most recent primary care visit:
October 2007
Body Mass Index 21
Cholesterol (mg/dL) 130
Triglyceride (mg/dL) 80
HDL (mg/dL) 47
LDL (mg/dL) 60
BP Systolic (mm Hg) 116
BP Diastolic (mm Hg) 72
Pulse rate (/min) 53
No Tums, no Motrin, no medications of any kind. I have extended my vegan lifestyle to eliminate animal products from my wardrobe, including all leather. My current clothing is entirely rayon/polyester with a bit of cotton, and shoes made from polyester microfiber. I feel I've done my part to reduce my carbon footprint, minimize my healthcare costs, and maximize my longevity. I do not attempt to inflict any philosophy on my friends and colleagues, but I can recommend vegetarianism/veganism. It worked for me!
Tuesday, November 20, 2007
What will keep me up at night in 2008
Every year, I have new infrastructure and application challenges. In 2002, I had an outage that required a major focus on replacing the entire data network. In 2007, a number of safety/quality related projects including medication reconciliation and automated chemotherapy ordering were my focus. What about 2008?
1. Stark safe harbors now enable hospitals to fund 85% of the implementation costs of electronic health records for non-owned physicians. I will be implementing a large hosting facility offering web-based electronic health records for 300 private physicians in New England.
2. Storage is increasingly an utility. This means that heat, power, light, networking and terabytes need to be provisioned on demand. Achieving a balance of highly reliable storage, archival storage, and backup at low cost will be a major body of work over the next year. This means I'll have to figure out the right combination of continuous data protection, hierarchical storage management, data de-duplication, virtual/actual tape libraries, and information lifecycle management. Of course we'll need to implement this new infrastructure in a "green" manner that keeps the entire power consumption of our data center under 220kw, our 2008 energy goal.
3. e-Prescribing means much more than just prescription routing. It means eligibility checking, formulary enforcement, community medication history sharing and decision support. We will complete the rollout of all of these features to all of our clinicians this year. We'll also have other medication safety initiatives are part of our pay for performance contracts including electronic medication administration records and protocol driven inpatient chemotherapy systems.
4. Data sharing for clinical care among a community of caregivers poses significant privacy policy and technology challenges. We are going live with clinical summary sharing using the Continuity of Care Document among the providers of BIDMC, Lahey, Children's and Northeast Health Systems in 2008.
5. Security is a journey that will require enhanced virus/malware protection, web content filtering, host-based intrusion protection, and intelligent audit trail reviews. Substantial staff resources will be required to safeguard patient confidentiality.
6. RFID and Bar coding will increasingly be used to identify patients, staff, medications and assets. Workflow will be driven by the proximity of patients, doctors, and supplies. Deploying the right technology for the right purpose will require several pilots.
7. Providing decision support to every level of the organization will require additional tools and staff. Quality improvement, outcomes measurement, pay for performance goals, and clinical research necessitate more analysts, data marts, and self service applications to supply information on a need to know basis.
8. Compliance requirements for new revenue cycle workflows including enhanced electronic data interchange for claims, national provider identifier support, and evolving coding methodologies will require substantial improvements to existing systems.
9. Internal and external websites need to be enhanced to support self-service publishing models, collaboration and new media. This means new content management systems, enhanced wikis/blogs/forums/whiteboards, and search engines.
10. Disaster recovery needs to be built into the design of every application. Recovery time must be on the order of hours and the recovery point objective is 100% data integrity. The only way to achieve this level of reliability is to have entirely redundant data centers.
For a list of the 200 different projects that will enable us to meet these goals, you'll find my 2008 BIDMC IS Operating plan here and my 2008 Harvard Medical School IS Operating plan here.
1. Stark safe harbors now enable hospitals to fund 85% of the implementation costs of electronic health records for non-owned physicians. I will be implementing a large hosting facility offering web-based electronic health records for 300 private physicians in New England.
2. Storage is increasingly an utility. This means that heat, power, light, networking and terabytes need to be provisioned on demand. Achieving a balance of highly reliable storage, archival storage, and backup at low cost will be a major body of work over the next year. This means I'll have to figure out the right combination of continuous data protection, hierarchical storage management, data de-duplication, virtual/actual tape libraries, and information lifecycle management. Of course we'll need to implement this new infrastructure in a "green" manner that keeps the entire power consumption of our data center under 220kw, our 2008 energy goal.
3. e-Prescribing means much more than just prescription routing. It means eligibility checking, formulary enforcement, community medication history sharing and decision support. We will complete the rollout of all of these features to all of our clinicians this year. We'll also have other medication safety initiatives are part of our pay for performance contracts including electronic medication administration records and protocol driven inpatient chemotherapy systems.
4. Data sharing for clinical care among a community of caregivers poses significant privacy policy and technology challenges. We are going live with clinical summary sharing using the Continuity of Care Document among the providers of BIDMC, Lahey, Children's and Northeast Health Systems in 2008.
5. Security is a journey that will require enhanced virus/malware protection, web content filtering, host-based intrusion protection, and intelligent audit trail reviews. Substantial staff resources will be required to safeguard patient confidentiality.
6. RFID and Bar coding will increasingly be used to identify patients, staff, medications and assets. Workflow will be driven by the proximity of patients, doctors, and supplies. Deploying the right technology for the right purpose will require several pilots.
7. Providing decision support to every level of the organization will require additional tools and staff. Quality improvement, outcomes measurement, pay for performance goals, and clinical research necessitate more analysts, data marts, and self service applications to supply information on a need to know basis.
8. Compliance requirements for new revenue cycle workflows including enhanced electronic data interchange for claims, national provider identifier support, and evolving coding methodologies will require substantial improvements to existing systems.
9. Internal and external websites need to be enhanced to support self-service publishing models, collaboration and new media. This means new content management systems, enhanced wikis/blogs/forums/whiteboards, and search engines.
10. Disaster recovery needs to be built into the design of every application. Recovery time must be on the order of hours and the recovery point objective is 100% data integrity. The only way to achieve this level of reliability is to have entirely redundant data centers.
For a list of the 200 different projects that will enable us to meet these goals, you'll find my 2008 BIDMC IS Operating plan here and my 2008 Harvard Medical School IS Operating plan here.
Monday, November 19, 2007
How to say "No"
I was recently asked to give a lecture about how I say "no" to new project requests. Of course I have governance committees which help prioritize all IT projects based on
Return on Investment
Quality/Compliance
Impact factor - number of doctors, nurses, staff and patients who will benefit
Alignment with the strategic needs of the business
Beyond my governance processes, which I will describe further in another post, my top 10 list of how to say "no" is more about people than prioritization.
10. Select your change (and what not to change)
I've learned that my hospital organization (BIDMC) does not readily accept off the shelf enterprise application software. In the past decade, we've stopped a major clinical and a major revenue cycle project because of the limited customization possibilities with vendor supplied software. To this day, our self-built customized enterprise applications keep customers happy at low cost. Of course I still buy many departmental systems (lab, critical care, anesthesia, labor and deliver monitoring, PACS, cardiology) but will no longer try to replace our enterprise clinical applications with vendor products. This is an automatic "no" that customers understand.
9. Identify those who will lose and take them to lunch
On a given day, 10% of the organization is not completely satisfied with the triage decisions made by my governance committees. In a world of limited supply and infinite demand, the organization needs to say "no" to many projects. I find that bad news does not travel well via email, hence personal contact is needed to explain many prioritization decisions. I try to make personal contact with those whose projects are not funded/prioritized. Whenever possible, instead of "never", I say "not now" to lower priority projects.
8. Acknowledge the loss
Many people will accept change if the process is transparent, they are involved in the decision, and their losses are acknowledged. Telling folks that you understand the impact of negative decisions and expressing a willingness to work together in the future goes a long way.
7. Over Communicate
Rumors are often worse than the truth. Every Friday I send out a broadcast email to the entire organization explaining issues, good news, bad news, and future plans.
6. Be Honest and Consistent
I work hard to tell all stakeholders the same message. If everyone hears the good and bad news consistently, the credibility of IT is enhanced.
5. Consensus is not essential
A vote of 500 to 1 is not a tie. If governance works objectively, even politically powerful stakeholders cannot veto prioritization decisions which are in the best interest of the organization.
4. Embrace conflict
Sometimes the right decisions are the hard or politically challenging ones. By expecting conflict every day, the CIO can make decisions more dispassionately. My training as an emergency physician prepared me to approach every situation with balanced emotions. Eliminating caffeine 5 years ago helped too.
3. Focus on your detractors
Sometimes organizations can be 1000 points of veto. By focusing on those who oppose projects instead of those which support them, I can use my time most effectively. I'd rather meet with my friends, but my day is optimized when I spend the day with my detractors. Sometimes detractors become friends, but at least all detractors understand the rationale for "no" decisions.
2. The last two minutes of the meeting are the most important
It's very common for politically challenging meetings to end with differing opinions as to what was discussed. Using the last two minutes of the meeting to review all the decisions made and next steps, then memorializing that conversation in written minutes, enhances the communication of "no"
1. You cannot please everyone
I accept that the good of the many outweighs the needs of the few, even if I have to be the "no" guy.
Return on Investment
Quality/Compliance
Impact factor - number of doctors, nurses, staff and patients who will benefit
Alignment with the strategic needs of the business
Beyond my governance processes, which I will describe further in another post, my top 10 list of how to say "no" is more about people than prioritization.
10. Select your change (and what not to change)
I've learned that my hospital organization (BIDMC) does not readily accept off the shelf enterprise application software. In the past decade, we've stopped a major clinical and a major revenue cycle project because of the limited customization possibilities with vendor supplied software. To this day, our self-built customized enterprise applications keep customers happy at low cost. Of course I still buy many departmental systems (lab, critical care, anesthesia, labor and deliver monitoring, PACS, cardiology) but will no longer try to replace our enterprise clinical applications with vendor products. This is an automatic "no" that customers understand.
9. Identify those who will lose and take them to lunch
On a given day, 10% of the organization is not completely satisfied with the triage decisions made by my governance committees. In a world of limited supply and infinite demand, the organization needs to say "no" to many projects. I find that bad news does not travel well via email, hence personal contact is needed to explain many prioritization decisions. I try to make personal contact with those whose projects are not funded/prioritized. Whenever possible, instead of "never", I say "not now" to lower priority projects.
8. Acknowledge the loss
Many people will accept change if the process is transparent, they are involved in the decision, and their losses are acknowledged. Telling folks that you understand the impact of negative decisions and expressing a willingness to work together in the future goes a long way.
7. Over Communicate
Rumors are often worse than the truth. Every Friday I send out a broadcast email to the entire organization explaining issues, good news, bad news, and future plans.
6. Be Honest and Consistent
I work hard to tell all stakeholders the same message. If everyone hears the good and bad news consistently, the credibility of IT is enhanced.
5. Consensus is not essential
A vote of 500 to 1 is not a tie. If governance works objectively, even politically powerful stakeholders cannot veto prioritization decisions which are in the best interest of the organization.
4. Embrace conflict
Sometimes the right decisions are the hard or politically challenging ones. By expecting conflict every day, the CIO can make decisions more dispassionately. My training as an emergency physician prepared me to approach every situation with balanced emotions. Eliminating caffeine 5 years ago helped too.
3. Focus on your detractors
Sometimes organizations can be 1000 points of veto. By focusing on those who oppose projects instead of those which support them, I can use my time most effectively. I'd rather meet with my friends, but my day is optimized when I spend the day with my detractors. Sometimes detractors become friends, but at least all detractors understand the rationale for "no" decisions.
2. The last two minutes of the meeting are the most important
It's very common for politically challenging meetings to end with differing opinions as to what was discussed. Using the last two minutes of the meeting to review all the decisions made and next steps, then memorializing that conversation in written minutes, enhances the communication of "no"
1. You cannot please everyone
I accept that the good of the many outweighs the needs of the few, even if I have to be the "no" guy.
Friday, November 16, 2007
Our Secure email strategy
Here's the third in my series on providing secure, spam free, virus free email to 25,000 users.
Regular email that travels over the internet is completely insecure. It's about the same as sending a postcard, since any server administrator or network expert could intercept and read mail as it goes from sender to receiver.
For healthcare email, especially messages containing protected health information (PHI), secure email between organizations is a best practice consistent with the spirit of HIPAA. Over the past 5 years, many organizations in the Massachusetts healthcare community have implemented secure email for all traffic between organizations.
We started the process the in 2002 by working with leading vendors of messaging systems to harmonize the standards used to send email. We used the Internet Engineering Task Force's (IETF) Request for Comment (RFC) process to complete the specifications for S/MIME Gateways. Since that time, another approach called Open Pretty Good Privacy (OpenPGP) has also become popular in the messaging market. A comparison of these two standards is here
Today, Beth Israel Deaconess Medical Center, Children's Hospital, Tufts Health Plan, Harvard Pilgrim Health Plan, and the Division of Medical Assistance (Medicaid) are using gateways that support S/MIME and OpenPGP. Here's how it works. Someone at BIDMC sends an email from a web browser or their email program and it passes into our Microsoft Exchange email server. Between Exchange and the internet, we've inserted the Tumbleweed Secure Messenger. It has a list of all our business partners with secure email systems. If an email is sent to one of these partners, the email is encrypted and sent to the receipient's secure email gateway. Other emails are sent insecurely via the regular internet methods. We are also piloting content filtering systems that identify insecure emails containing credit card data or patient identifiers so we can quarantine those before they are sent over the public internet.
The best feature about this secure email approach is that users do not even know we have it in place. Security is organization to organization, not person to person, so no special email clients or digital certificates are needed. It's seamless, effective and low cost.
As you can tell from my last three posts, supporting spam-free, virus free email is a major undertaking.
Regular email that travels over the internet is completely insecure. It's about the same as sending a postcard, since any server administrator or network expert could intercept and read mail as it goes from sender to receiver.
For healthcare email, especially messages containing protected health information (PHI), secure email between organizations is a best practice consistent with the spirit of HIPAA. Over the past 5 years, many organizations in the Massachusetts healthcare community have implemented secure email for all traffic between organizations.
We started the process the in 2002 by working with leading vendors of messaging systems to harmonize the standards used to send email. We used the Internet Engineering Task Force's (IETF) Request for Comment (RFC) process to complete the specifications for S/MIME Gateways. Since that time, another approach called Open Pretty Good Privacy (OpenPGP) has also become popular in the messaging market. A comparison of these two standards is here
Today, Beth Israel Deaconess Medical Center, Children's Hospital, Tufts Health Plan, Harvard Pilgrim Health Plan, and the Division of Medical Assistance (Medicaid) are using gateways that support S/MIME and OpenPGP. Here's how it works. Someone at BIDMC sends an email from a web browser or their email program and it passes into our Microsoft Exchange email server. Between Exchange and the internet, we've inserted the Tumbleweed Secure Messenger. It has a list of all our business partners with secure email systems. If an email is sent to one of these partners, the email is encrypted and sent to the receipient's secure email gateway. Other emails are sent insecurely via the regular internet methods. We are also piloting content filtering systems that identify insecure emails containing credit card data or patient identifiers so we can quarantine those before they are sent over the public internet.
The best feature about this secure email approach is that users do not even know we have it in place. Security is organization to organization, not person to person, so no special email clients or digital certificates are needed. It's seamless, effective and low cost.
As you can tell from my last three posts, supporting spam-free, virus free email is a major undertaking.
Thursday, November 15, 2007
Supporting electronic health records for non-owned doctors
Implementing electronic health records requires transformation of a medical practice. It's more about workflow and change management than technology. In Massachusetts, competitive pressures, pay for performance contracts, and increasing demands from specialists to be connected to primary care givers are motivating clinicians to install electronic health records. The challenge is how to pay for them and how to provide the services necessary to ensure successful implementation.
Recently, Stark regulations have been changed to enable hospitals to fund up to 85% of the implementation costs of electronic health records for non-owned clinicians. This means that hundreds of clinicians in the community are now looking to BIDMC as an information technology provider. Although we oversee 200 trillion bytes of data, 16000 network connections, 8000 personal computers, and 150 applications, it's challenging to scale our team to support hundreds of new physician practices in the community.
How will we do it?
We've partnered with a dream team of collaborators to build a robust, cost effective, web-accessible electronic health record hosting facility that goes live in early 2008. Our partners include
eClinicalWorks - a leading provider of practice management and CCHIT certified electronic health records, accessible over the inernet using a smart web client, from anywhere in the world
Concordant - a leading provider of desktop, network, and server hosting services for clinician offices throughout our region.
MassPro - a regional peer review organization which provides best practice templates for physicians implementing electronic health records and which created DOQ-IT University, a training program for professionals implementing physician automation. It's also a leader in quality measurement
Massachuetts eHealth Collaborative - our regional implementer of electronic health records with expertise in practice transformation.
Third Brigade - an expert internet security firm, which will audit all our systems to ensure we are protecting patient confidentiality.
Working together with these collaborators, BIDMC will offer a suite of services that enable us to expand the scale of our current IS operations into the community. My team and I will continue to provide the medical informatics expertise, decision support knowledge, and interoperability standards, but our team of partners will help us execute the vision in a way that enables us to balance time, scope and resources.
Recently, Stark regulations have been changed to enable hospitals to fund up to 85% of the implementation costs of electronic health records for non-owned clinicians. This means that hundreds of clinicians in the community are now looking to BIDMC as an information technology provider. Although we oversee 200 trillion bytes of data, 16000 network connections, 8000 personal computers, and 150 applications, it's challenging to scale our team to support hundreds of new physician practices in the community.
How will we do it?
We've partnered with a dream team of collaborators to build a robust, cost effective, web-accessible electronic health record hosting facility that goes live in early 2008. Our partners include
eClinicalWorks - a leading provider of practice management and CCHIT certified electronic health records, accessible over the inernet using a smart web client, from anywhere in the world
Concordant - a leading provider of desktop, network, and server hosting services for clinician offices throughout our region.
MassPro - a regional peer review organization which provides best practice templates for physicians implementing electronic health records and which created DOQ-IT University, a training program for professionals implementing physician automation. It's also a leader in quality measurement
Massachuetts eHealth Collaborative - our regional implementer of electronic health records with expertise in practice transformation.
Third Brigade - an expert internet security firm, which will audit all our systems to ensure we are protecting patient confidentiality.
Working together with these collaborators, BIDMC will offer a suite of services that enable us to expand the scale of our current IS operations into the community. My team and I will continue to provide the medical informatics expertise, decision support knowledge, and interoperability standards, but our team of partners will help us execute the vision in a way that enables us to balance time, scope and resources.
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