BIDMC has 4 Apple Watches (the inexpensive Sport model) for development and evaluation. Our programmers have 3 of them and I’m passing the 4th around to various folks including a 65 year old techie and a 22 year old digital native (my daughter Lara). Here’s Lara’s review:
“As the Apple Watch arrives at retail stores, a lot of people will be asking 'How is it? Is it worth buying?' I think a question that needs to be asked first, however, is ‘What is it?’ The Apple Watch is not a new, independent Apple product. It is a watch that pairs with your iPhone and acts as a mirror of sorts, enabling you to access select apps and features from your phone. It is not an independent product. I was certainly surprised by that!
Just as the iPhone functions very well as a phone, the watch also functions very well as a watch. The Sport Band is incredibly comfortable, and easily adjustable. It has a very clear, readable face with both digital and analog options, as well as a small selection of customizable watch faces. (Honestly, I hope they add more selection over time- its currently quite limited.) You can display a few other bits of information on the screen, such as the date, weather, and other time zones. The customizability here is definitely a highlight, and a feature that goes beyond a standard wristwatch.
But let’s be honest here- nobody cares much about the iPhone’s phone capabilities. They care about the apps. I imagine the Apple Watch will be viewed in the same way. ‘What nifty non-watch things can I do on my Apple Watch?’ Well, this is where the product falls slightly short at the moment. The Apple Watch is an interface for some select apps, but with less features than that of the iPhone. You can read your texts and emails, but you cannot write them (Unless you do so through dictation, but talking to your wrist in public does not look as cool as it does in the movies, trust me.) You can activate the camera on your phone with it, but it doesn’t have a camera of its own. (Funny story- I thought the camera was on the watch itself, and took plenty of lovely pictures of the wall while trying to figure out what was going on.)
On the flip side, some apps are designed very well for the watch. The health app in particular does a great job of utilizing what the watch has to offer. I was especially fond of the little notification it gives you when you’ve been sitting down for over 50 minutes. It’s a perfect reminder for when I lose track of time on my computer. I’ve also found some nifty vocabulary and kanji flashcards that have helped me with my Japanese studies. I’m sure that over time, more apps will be released that are compatible with and suited to the Apple Watch, and I’m looking forward to trying them out.
On a final note, for anyone worried about the battery life- the first time you use it, while setting up the watch itself, the battery drains quickly. Every time after that, it will last you the entire day. Have the charger set up on your bedside and you’re good to go.
So, is the Apple Watch worth the price tag? Well, that depends on what you’re looking for. If you’re looking to replace your iPhone, then no. But if you’re looking for a very high quality watch with limited iPhone features and app use, then yes. I love my watch for what it is- a watch with some perks. "
Friday, June 26, 2015
Thursday, June 25, 2015
Unity Farm Journal - Fourth Week of June 2015
We brought our alpaca mom and new baby, Daisy and Danny, home after a brief thunderstorm cleared. Nature concluded what we’ve always known - Unity Farm is the end of the rainbow.
Mom and baby are healthy, happy and content. Daisy has become an overprotective mom and Danny eats vigorously every hour. We’ve kept them in a shaded pen to give them quiet recovery time from the trauma of being driven to a hospital and kept away from the farm for 4 days. Danny’s IgG is nearly 1700, which means he has a fully intact immune system. He’s gained a few pounds and is a non-stop bundle of energy.
What a great outcome.
We moved the geese outdoors into the duck pen. The geese are happy but the ducks are not sure. They tend to hide inside the duck house. We’ll keep the geese in the pen for a few days so that they recognize it as home before letting them free range. We’ve had a female coyote visiting a few times a day this week, so we want to be conservative on releasing new animals to free range.
We moved 17 chicks into our mini-coops inside the main coop. We added buff orpingtons, barred rocks, cuckoo marans, americaunas, and andalusians In another 6 weeks, they’ll also free range.
The mead is nearly fully fermented. It started with a specific gravity of 1.100 and now is at 1.010. We expect about 14% alcohol. I’ll age it for one year before bottling.
The bees continue to gather nectar from the acres of summer wildflowers growing in the orchard. The hives are so large and healthy that Kathy needs a ladder to maintain them. So far, no swarms from the Unity Farm hives!
We are harvesting strawberries, peas, cucumbers, broccoli, and chard this week. The garlic harvest is approaching and many of our tomatoes are large and plump.
Inspired by our bounty of tomatoes, mushrooms, fresh basil, and more garlic than we can consume, I’m convinced my next project should be building a wood-fired pizza oven. I have to do something with the extra cords of wood we store for winter every year - why not whole wheat thin crust!
This weekend will be filled with trimming and trail maintenance tasks now that the burst of Summer growth has turned our orchard and trails into a wilderness. Some weekends are animal focused and some are plant focused. Not a single weekend goes by without a new adventure.
Mom and baby are healthy, happy and content. Daisy has become an overprotective mom and Danny eats vigorously every hour. We’ve kept them in a shaded pen to give them quiet recovery time from the trauma of being driven to a hospital and kept away from the farm for 4 days. Danny’s IgG is nearly 1700, which means he has a fully intact immune system. He’s gained a few pounds and is a non-stop bundle of energy.
What a great outcome.
We moved the geese outdoors into the duck pen. The geese are happy but the ducks are not sure. They tend to hide inside the duck house. We’ll keep the geese in the pen for a few days so that they recognize it as home before letting them free range. We’ve had a female coyote visiting a few times a day this week, so we want to be conservative on releasing new animals to free range.
We moved 17 chicks into our mini-coops inside the main coop. We added buff orpingtons, barred rocks, cuckoo marans, americaunas, and andalusians In another 6 weeks, they’ll also free range.
The mead is nearly fully fermented. It started with a specific gravity of 1.100 and now is at 1.010. We expect about 14% alcohol. I’ll age it for one year before bottling.
The bees continue to gather nectar from the acres of summer wildflowers growing in the orchard. The hives are so large and healthy that Kathy needs a ladder to maintain them. So far, no swarms from the Unity Farm hives!
We are harvesting strawberries, peas, cucumbers, broccoli, and chard this week. The garlic harvest is approaching and many of our tomatoes are large and plump.
Inspired by our bounty of tomatoes, mushrooms, fresh basil, and more garlic than we can consume, I’m convinced my next project should be building a wood-fired pizza oven. I have to do something with the extra cords of wood we store for winter every year - why not whole wheat thin crust!
This weekend will be filled with trimming and trail maintenance tasks now that the burst of Summer growth has turned our orchard and trails into a wilderness. Some weekends are animal focused and some are plant focused. Not a single weekend goes by without a new adventure.
Wednesday, June 24, 2015
The June 2015 HIT Standards Committee
The June 2015 HIT Standards Committee focused on celebrating the accomplishments of those individuals who have reached their federal advisory committee term limits. Most served 6 years:
Dixie Baker
Anne Castro
Marty Harris
David McCallie
Stan Huff
Liz Johnson
John Derr
Sharon Terry
Jon Perlin
Jeremy Delinsky
Karen DeSalvo thanked each one and I offered comments about their unique contributions, changing the fundamental trajectory of standards in the US from a 1990’s “EDI” payload model to a 2015 “Facebook” Application Program Interface model. Their leadership has brought modern, open web standards to the healthcare domain, specified controlled vocabularies, and established appropriate security. They will be missed.
Next, John Feikema and Dragon Bashyam presented a summary of the Data Access Framework project. We thanked them for the foundational work that has been incorporated into the private sector Argonaut project.
Chris Muir provided an Interoperability Standards Advisory Update and described the process by which a task force will refine the FY16 sub regulatory guidance. While regulation generally includes only mature standards, sub regulatory guidance can enumerate emerging standards that are likely to become mature.
The next portion of the meeting focused on the final recommendations of the committee for the standards to include in regulation and those to specifically exclude from regulation.
We highlighted the measures of maturity that Dixie Baker outlined in her paper about standards readiness.
We emphasized that standards require a business case, policy enablers, and supporting infrastructure. As David McCallie wrote, Standards Alone are not the Answer for Interoperability.
In that spirit, Rich Elmore presented the recommendations from the Content Standards Workgroup
Mitra Rocca presented the recommendations of the Semantic Standards Workgroup
David McCallie and Arien Malec presented the recommendations of the Architecture, Services, and APIs Workgroup
Liz Johnson and Cris Ross presented the recommendations of the Implementation, Certification, and Testing Workgroup
The themes included:
*CCDA is mature but needs to significantly constrained
*FHIR is nearly ready for widespread use and should be highlighted as directional
*Quality standards such as HQMF and QRDA will be refined in their next version
*Many standards are just not ready for regulatory or sub regulatory recommendation including HPD+ (provider directory), eSMD (electronic submission of medical documentation), DS4P (data segmentation for privacy), and HeD (Healthy Decisions)
*Providing a laundry list of immature standards is not going to accelerate interoperability
After the meeting I spoke with several members about writing a journal article that will summarize the lessons we’ve learned providing standards advice for the Obama administration. The most significant point is that interoperability doesn’t happen when standards are named. Interoperability happens when there is a business case, trust between two parties, and governance over the process. It generally takes a few years to achieve all the enablers and there is no magic standard that will make the cultural and policy changes needed to accelerate information flow.
Dixie Baker
Anne Castro
Marty Harris
David McCallie
Stan Huff
Liz Johnson
John Derr
Sharon Terry
Jon Perlin
Jeremy Delinsky
Karen DeSalvo thanked each one and I offered comments about their unique contributions, changing the fundamental trajectory of standards in the US from a 1990’s “EDI” payload model to a 2015 “Facebook” Application Program Interface model. Their leadership has brought modern, open web standards to the healthcare domain, specified controlled vocabularies, and established appropriate security. They will be missed.
Next, John Feikema and Dragon Bashyam presented a summary of the Data Access Framework project. We thanked them for the foundational work that has been incorporated into the private sector Argonaut project.
Chris Muir provided an Interoperability Standards Advisory Update and described the process by which a task force will refine the FY16 sub regulatory guidance. While regulation generally includes only mature standards, sub regulatory guidance can enumerate emerging standards that are likely to become mature.
The next portion of the meeting focused on the final recommendations of the committee for the standards to include in regulation and those to specifically exclude from regulation.
We highlighted the measures of maturity that Dixie Baker outlined in her paper about standards readiness.
We emphasized that standards require a business case, policy enablers, and supporting infrastructure. As David McCallie wrote, Standards Alone are not the Answer for Interoperability.
In that spirit, Rich Elmore presented the recommendations from the Content Standards Workgroup
Mitra Rocca presented the recommendations of the Semantic Standards Workgroup
David McCallie and Arien Malec presented the recommendations of the Architecture, Services, and APIs Workgroup
Liz Johnson and Cris Ross presented the recommendations of the Implementation, Certification, and Testing Workgroup
The themes included:
*CCDA is mature but needs to significantly constrained
*FHIR is nearly ready for widespread use and should be highlighted as directional
*Quality standards such as HQMF and QRDA will be refined in their next version
*Many standards are just not ready for regulatory or sub regulatory recommendation including HPD+ (provider directory), eSMD (electronic submission of medical documentation), DS4P (data segmentation for privacy), and HeD (Healthy Decisions)
*Providing a laundry list of immature standards is not going to accelerate interoperability
After the meeting I spoke with several members about writing a journal article that will summarize the lessons we’ve learned providing standards advice for the Obama administration. The most significant point is that interoperability doesn’t happen when standards are named. Interoperability happens when there is a business case, trust between two parties, and governance over the process. It generally takes a few years to achieve all the enablers and there is no magic standard that will make the cultural and policy changes needed to accelerate information flow.
Monday, June 22, 2015
Driving Miss Daisy
It’s been a long weekend. Here’s the story of the birth of our new Alpaca, Dandelion Wine (Danny)
On Thursday at 12:03pm, Kathy texted me the picture below and the message “HELP!” Mom had delivered the long legs of a new baby. I rushed back to the farm and by the time I arrived, baby and placenta had been successfully delivered by Daisy Mae, with Kathy’s help. The newborn weighed 18 pounds. Typical for an alpaca is 10-17 pounds. Since Daisy Mae is a small alpaca (140 pounds), the birth was very difficult. You can see how big he is - my daughter is 5 foot 5 inches and she is holding him shortly after birth.
I examined Daisy and she had no tears or bleeding. However, she was very tired and rejected the baby’s attempts to nurse. Alpaca babies generally start nursing within 90 minutes and have about 24 hours to consume colostrum - the early mother’s milk that provides them with an immune system. If they do not eat, they have no immune system and can easily die of infection.
We gently haltered Daisy Mae and held her while encouraging Danny to eat. Mom and baby just could not collaborate. We tried restraining Daisy. No luck. We had to initiate bottle feeding to keep Danny hydrated. We put him in a cria coat (a down jacket for baby alpaca) for the night since mom was not keeping him warm. However, the rest of the herd protected him.
All day Friday we tried keeping them together and encouraging bonding. It did not work. As the window closed for colostrum transfer, we had to proceed to plan B - transfusion with alpaca plasma to provide the IgG he needed to fight off infection. We drove him to Tufts large animal hospital in Grafton, MA. They infused plasma and his IgG counts rose slowly. He did not develop a fever and his white count was normal.
While Danny was being treated, we also had to treat Daisy - she was not nursing and she was at risk for mastitis. We had to massage her teets every two hours to express milk and reduce the risk of infection. She became more agitated with every treatment. Clearly she was not dealing with motherhood very well, which is typical for first time alpaca moms.
Transfusions continued for Danny on Saturday and counts were rising but slower than expected, although he looked clinically well. Thus, we had two patients, a young patient with IgG counts rising slowly and a mom increasingly agitated. Saturday was frustrating.
We made a decision that we had to bring them together so that as his counts became normal, he could be re-introduced to her and she could be sedated if necessary so that nursing could proceed. It’s typical for horses that a few hours of sedation can lead to a successful mother-baby feeding/bonding experience. We lifted all 140 pounds of Daisy into the Ford Transit truck and drove her to the Tufts facility. We checked her in, and spent an hour with Danny. Clearly he missed his herd.
Mother and baby were re-united on Sunday night. Danny was joyful, Daisy was skeptical. She was mildly sedated and he began to feed. By late Sunday night, Daisy was mothering him without sedation.
If all goes well, Danny’s transfusions will be done today and Daisy will be a fully functional mother. If we’re lucky, tonight we’ll put them both in the van and bring them back to Unity Farm.
Such is the life of a farmer - you never know what the future will bring.
On Thursday at 12:03pm, Kathy texted me the picture below and the message “HELP!” Mom had delivered the long legs of a new baby. I rushed back to the farm and by the time I arrived, baby and placenta had been successfully delivered by Daisy Mae, with Kathy’s help. The newborn weighed 18 pounds. Typical for an alpaca is 10-17 pounds. Since Daisy Mae is a small alpaca (140 pounds), the birth was very difficult. You can see how big he is - my daughter is 5 foot 5 inches and she is holding him shortly after birth.
I examined Daisy and she had no tears or bleeding. However, she was very tired and rejected the baby’s attempts to nurse. Alpaca babies generally start nursing within 90 minutes and have about 24 hours to consume colostrum - the early mother’s milk that provides them with an immune system. If they do not eat, they have no immune system and can easily die of infection.
We gently haltered Daisy Mae and held her while encouraging Danny to eat. Mom and baby just could not collaborate. We tried restraining Daisy. No luck. We had to initiate bottle feeding to keep Danny hydrated. We put him in a cria coat (a down jacket for baby alpaca) for the night since mom was not keeping him warm. However, the rest of the herd protected him.
All day Friday we tried keeping them together and encouraging bonding. It did not work. As the window closed for colostrum transfer, we had to proceed to plan B - transfusion with alpaca plasma to provide the IgG he needed to fight off infection. We drove him to Tufts large animal hospital in Grafton, MA. They infused plasma and his IgG counts rose slowly. He did not develop a fever and his white count was normal.
While Danny was being treated, we also had to treat Daisy - she was not nursing and she was at risk for mastitis. We had to massage her teets every two hours to express milk and reduce the risk of infection. She became more agitated with every treatment. Clearly she was not dealing with motherhood very well, which is typical for first time alpaca moms.
Transfusions continued for Danny on Saturday and counts were rising but slower than expected, although he looked clinically well. Thus, we had two patients, a young patient with IgG counts rising slowly and a mom increasingly agitated. Saturday was frustrating.
We made a decision that we had to bring them together so that as his counts became normal, he could be re-introduced to her and she could be sedated if necessary so that nursing could proceed. It’s typical for horses that a few hours of sedation can lead to a successful mother-baby feeding/bonding experience. We lifted all 140 pounds of Daisy into the Ford Transit truck and drove her to the Tufts facility. We checked her in, and spent an hour with Danny. Clearly he missed his herd.
Mother and baby were re-united on Sunday night. Danny was joyful, Daisy was skeptical. She was mildly sedated and he began to feed. By late Sunday night, Daisy was mothering him without sedation.
If all goes well, Danny’s transfusions will be done today and Daisy will be a fully functional mother. If we’re lucky, tonight we’ll put them both in the van and bring them back to Unity Farm.
Such is the life of a farmer - you never know what the future will bring.
Thursday, June 18, 2015
Unity Farm Journal - Third Week of June 2015
Last week’s 3 inches of rain yielded this week’s 50 pounds of Shitake. Here’s a few photos of the massive mushroom harvest.
The winecaps, agaricus, and wild mushrooms in our forest are also fruiting abundantly. Our permaculture efforts, including the recently planted paw-paw trees, are fully leafed out We’ve not yet seen much activity in our ginseng beds. I have a feeling that the deer and wild turkeys are eating them.
Now that all our ciders are fully mature, Kathy and I did a tasting of 7 different five gallon batches. All were technically perfect and had no off flavors. We are now able to focus our future efforts based on the aroma, complexity, and mouth feel we can achieve using different combinations of sweet, tart, aromatic, and astringent apples.
9/13
Sweet - Golden, Gala
Tart - McIntosh, Rhode Island Greening, Gravenstein
Aromatic -
Astringent -
lightly carbonated, clean/dry, primarily tart character
9/27
Sweet - Honey Crisp
Tart - McIntosh
Aromatic - Macoun
Astringent - Crab
moderately carbonated, clean/dry, complex/complete/balanced, aromatic
10/11
Sweet - Baldwin
Tart - McIntosh
Aromatic - Macoun
Astringent - Crab
moderately carbonated, clean/dry, less complex
10/25 *****The Winner
Sweet - Baldwin, Golden Delicious
Tart - McIntosh
Aromatic - Macoun
Astringent - Crab
moderately carbonated, clean/dry, complex/complete/balanced, aromatic
10/26
Sweet - Baldwin
Tart - Winesap
Aromatic -
Astringent - Crab
moderately carbonated, clean/dry, more tart, less complex
11/8
Sweet - Baldwin
Tart - Red Spy
Aromatic - Macoun
Astringent - Russet
moderatedly carbonated, clean/dry, rounded, buttery, very wine like
11/9
Sweet - Baldwin, Golden Delicious
Tart - Winesap, Cortland
Aromatic -
Astringent -
moderatedly carbonated, clean/dry, lacks complexity
We also ordered another 4 kegs so that we can keep 8 different kinds of beverages on our tap system as part of our product development. I’m adding a keg of honey lager next week and a keg of sparkling mead this Summer.
We’re still on cria (baby alpaca) watch - Daisy Mae has not yet given birth, although it is clear she is near. He’s a photo of Sunny, who is 1 year old this month.
We continue to raise our young Spring birds - chickens, geese, and pheasants. At the moment, our bird count is
Ducks - 8
Chickens - 26
Geese - 3
Guinea Fowl - 65
Our goal is to keep the guinea fowl population from expanding. We try to discover their hidden forest nests and gather their eggs on a daily basis.
The hives continue to grow and Kathy now has to use a step ladder to take off the honey supers. We have 22 hives, 12 at Unity Farm and 10 at five distributed locations within a few miles. Below is a photo of one of our queens - look at the center of the picture for the bee with the black thorax.
Our vegetables continue to be prolific and we’re harvesting 20 pounds per day for family, friends, and creatures. The strawberries are ripe and I’m eating them for breakfast, lunch and dinner. The monarch butterfly caterpillars are feasting on milkweed and the wild flowers are in bloom all over the pastures. It's almost Summer.
The winecaps, agaricus, and wild mushrooms in our forest are also fruiting abundantly. Our permaculture efforts, including the recently planted paw-paw trees, are fully leafed out We’ve not yet seen much activity in our ginseng beds. I have a feeling that the deer and wild turkeys are eating them.
Now that all our ciders are fully mature, Kathy and I did a tasting of 7 different five gallon batches. All were technically perfect and had no off flavors. We are now able to focus our future efforts based on the aroma, complexity, and mouth feel we can achieve using different combinations of sweet, tart, aromatic, and astringent apples.
9/13
Sweet - Golden, Gala
Tart - McIntosh, Rhode Island Greening, Gravenstein
Aromatic -
Astringent -
lightly carbonated, clean/dry, primarily tart character
9/27
Sweet - Honey Crisp
Tart - McIntosh
Aromatic - Macoun
Astringent - Crab
moderately carbonated, clean/dry, complex/complete/balanced, aromatic
10/11
Sweet - Baldwin
Tart - McIntosh
Aromatic - Macoun
Astringent - Crab
moderately carbonated, clean/dry, less complex
10/25 *****The Winner
Sweet - Baldwin, Golden Delicious
Tart - McIntosh
Aromatic - Macoun
Astringent - Crab
moderately carbonated, clean/dry, complex/complete/balanced, aromatic
10/26
Sweet - Baldwin
Tart - Winesap
Aromatic -
Astringent - Crab
moderately carbonated, clean/dry, more tart, less complex
11/8
Sweet - Baldwin
Tart - Red Spy
Aromatic - Macoun
Astringent - Russet
moderatedly carbonated, clean/dry, rounded, buttery, very wine like
11/9
Sweet - Baldwin, Golden Delicious
Tart - Winesap, Cortland
Aromatic -
Astringent -
moderatedly carbonated, clean/dry, lacks complexity
We also ordered another 4 kegs so that we can keep 8 different kinds of beverages on our tap system as part of our product development. I’m adding a keg of honey lager next week and a keg of sparkling mead this Summer.
We’re still on cria (baby alpaca) watch - Daisy Mae has not yet given birth, although it is clear she is near. He’s a photo of Sunny, who is 1 year old this month.
We continue to raise our young Spring birds - chickens, geese, and pheasants. At the moment, our bird count is
Ducks - 8
Chickens - 26
Geese - 3
Guinea Fowl - 65
Our goal is to keep the guinea fowl population from expanding. We try to discover their hidden forest nests and gather their eggs on a daily basis.
The hives continue to grow and Kathy now has to use a step ladder to take off the honey supers. We have 22 hives, 12 at Unity Farm and 10 at five distributed locations within a few miles. Below is a photo of one of our queens - look at the center of the picture for the bee with the black thorax.
Our vegetables continue to be prolific and we’re harvesting 20 pounds per day for family, friends, and creatures. The strawberries are ripe and I’m eating them for breakfast, lunch and dinner. The monarch butterfly caterpillars are feasting on milkweed and the wild flowers are in bloom all over the pastures. It's almost Summer.
Wednesday, June 17, 2015
Setting Clinical IT Priorities
In my previous writing, I’ve suggested that the federal government co-opted our Clinical IT agenda over the past three years with Meaningful Use Stage 2, ICD-10, the HIPAA Omnibus Rule, and the Affordable Care Act (ACA).
Now that Stage 2 attestation is done, ICD-10 is on a trajectory for October go live, OCR/OIG/internal security audit activities are done for the moment, and the care management medical record we need to support the Affordable Care Act is live, we can once again ask our customers to help set priorities.
Here’s the process we’re following:
In June, we’re convening a group of senior VPs, clinicians, and IT professionals to jointly review the current HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 7 criteria and benchmark ourselves. It’s likely that we’ll amend the HIMSS criteria in a few areas where BIDMC considers itself a market leader - patient family engagement, mobile technologies, big data analytics, and cloud adoption. We’ll then identify gaps in functionality/workflow to focus our strategic goals for FY16.
Once we have identified the goals, we’ll ensure we have the right organizational structure and staffing to accomplish those goals. We’ll verify the operating and capital budgets required. We’ll create Gantt charts and resource leveling artifacts to illustrate the relationship among the scope of projects, timing, and resources.
These artifacts will be used in FY16 by all our clinical governance bodies. As new projects are mandated by government, mergers/acquisitions, or changes in local requirements, additions will be weighed against the scope, timelines, and resources already allocated.
I expect FY16 to be focused on the clinical documentation needed to support ICD-10, quality measurement, and care coordination.
It will be interesting to see what projects bubble up to the top and to identify the gaps between the ideal state of an academic medical center and our current state.
I’m hopeful that the process will have such transparency and inclusiveness that it will be an effective means to align supply and demand in FY16, increasing customer satisfaction by documenting the prioritized goals and communicating the progress we’re making.
Now that Stage 2 attestation is done, ICD-10 is on a trajectory for October go live, OCR/OIG/internal security audit activities are done for the moment, and the care management medical record we need to support the Affordable Care Act is live, we can once again ask our customers to help set priorities.
Here’s the process we’re following:
In June, we’re convening a group of senior VPs, clinicians, and IT professionals to jointly review the current HIMSS Electronic Medical Record Adoption Model (EMRAM) Stage 7 criteria and benchmark ourselves. It’s likely that we’ll amend the HIMSS criteria in a few areas where BIDMC considers itself a market leader - patient family engagement, mobile technologies, big data analytics, and cloud adoption. We’ll then identify gaps in functionality/workflow to focus our strategic goals for FY16.
Once we have identified the goals, we’ll ensure we have the right organizational structure and staffing to accomplish those goals. We’ll verify the operating and capital budgets required. We’ll create Gantt charts and resource leveling artifacts to illustrate the relationship among the scope of projects, timing, and resources.
These artifacts will be used in FY16 by all our clinical governance bodies. As new projects are mandated by government, mergers/acquisitions, or changes in local requirements, additions will be weighed against the scope, timelines, and resources already allocated.
I expect FY16 to be focused on the clinical documentation needed to support ICD-10, quality measurement, and care coordination.
It will be interesting to see what projects bubble up to the top and to identify the gaps between the ideal state of an academic medical center and our current state.
I’m hopeful that the process will have such transparency and inclusiveness that it will be an effective means to align supply and demand in FY16, increasing customer satisfaction by documenting the prioritized goals and communicating the progress we’re making.
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