Health IT professionals are in the business of disrupting the status quo!
Tools like these help make sense and provide insights:
Check out the graph, especially the context view.
- Blue is for Principles
- Orange is for Tactics
- Red is for Theories
- Green is for Case Studies
- Purple is for Practitioners
I’m not sure why this is even an issue.
Nurses are important stakeholders in the development, design and implementation of EMRs, especially in hospitals. I make it a point to have the Nursing IT Advisory Committee involved in any project that affects nursing workflows, processes and workloads.
Here are some practical lessons why they should be involved.
- They welcome changes that would make documentation easier and help them focus on patient care.
- They can be early adopters of electronic clinical documentation.
- They are the workforce of the hospital and their data output is huge!
- Their data output (vital sings, flow sheets, medication administration records, intake/output) are great candidates for multiple data representation, e.g. data grid, chronological view, trending graphs.
- They can hold the keys to physician engagement for clinical documentation and CPOE.
At The Medical City, we are working together with the nurses to help implement nursing documentation for our hospital EMR.
- How do you get nurses involved in your projects?
- Are they open to changes that might come with EMRs?
I got several emails (a few hours apart) asking the same series of questions about the state of HL7 in the Philippines. It’s for an assignment and they obviously found my blog for their research.
I am happy to share whatever I know so let me answer the questions in my blog.
What is the status of HL7 in the Philippines?
HL7 as a messaging protocol is being used by several Philippine hospitals. I am sure that St. Luke’s Medical Center (both QC and GC) and The Medical City use HL7 to integrate ancillary systems, e.g. Laboratory Information Systems, Radiology Information Systems, with Hospital Information Systems.
However, I’m sure there are other hospitals using HL7 for integration–though may not explicitly know about it. Some of the analyzer vendors I’ve worked with during integration projects were using HL7 in their interfaces but didn’t know anything about HL7 as a protocol, standard or organization. (That’s another story!)
There is also an ongoing multi-sectoral effort to get the Philippines affiliated with HL7.org. If this is successful, we’d have an official HL7 Philippines listed in this page: HL7 International Council. So far, the effort is doing well. We might have very positive news soon!
How will HL7 affect the healthcare industry in the future?
HL7 is the key to standards-driven healthcare interoperability. Interoperability and integration are the keys to improved IT-enabled clinical workflows.
What this all means is that if we plan to computerize clinical workflows, we need to integrate several health IT systems. These systems perform specific functions inside hospitals, e.g. ICU monitors, lab results, radiological images, and they should talk to each other. The way to talk to each other is via a messaging standard like HL7.
Better integration among systems can help improve adoption. Thus, if we do HL7 right, we might see more healthcare IT systems available in the market. This, in turn, will help lower costs of implementing clinical applications in hospitals.
What is the government’s stand on HL7?
The government is pro-HL7!
DOH is doing several multi-sectoral efforts to improve healthcare in the Philippines using Information and Communication Technologies. They are working on a national eHealth framework. Although implementation and technical details are still being developed with both public and private groups, HL7 will form part of the core standards to be implemented nationwide.
Check this links for more information about the DOH activities:
- Philippines eHealth Strategic Framework and Plan 2013-2017 (Version 3.0)
- AO 2013-0025 – National Implementation of Health Data Standards for eHealth Standardization and Interoperability (eHSI Release 001)
Thanks to everyone who emailed me. I hope this post helped.
Please email questions or post in the comments.
I’ll be giving a short Webinar about HL7 on September 9, 2013, Monday, 8pm.
Here’s the registration link to join: Webinar registration: Introduction to HL7.
Starting this month (June 2013), I won’t be CIO of The Medical City anymore. I will be redefining my scope of work for the hospital to focus on clinician engagement (MDs, RNs and other health staff) and clinical IT projects.
For over 2 years as TMC CIO, I worked only 3 days per week (Tuesdays to Thursdays). This was mainly due to my family commitments. It worked for some time, I guess. I was able to implement changes in our IT processes, projects and deliverables. But as the needs of the TMC network of hospitals and clinics continue to grow, so does the need for a full-time CIO. So we started a search for my replacement. And we are happy to have found a highly competent person for the job. He starts this month.
As for me, I will be staying on to focus on the long-term EMR development and implementation project. There is still so much more to be done.
I am excited to focus on these challenges–to work with clinicians, to improve workflows, to implement computerized medical records and to integrate IT systems.
Let the new chapter begin!
We are doing Round 3 of Nursing Informatics Training Program at The Medical City.
Target start date is July 1, 2013. Applicant interviews will start as soon as possible. Training program will take 14-16 weeks to complete depending on the projects assigned.
Projects may include:
- Nursing module
- Medication Treatment Record
- Vital Signs Monitoring Sheet
- Input/Output Monitoring
Interested nurses should review original post and submit their Letters of Interest (short essay on why they want to join) and CVs to mbmuin(at)medicalcity.com.ph. Letters of interest can be placed in the body of the email.
(Application period has been extended.)
The IT Department of The Medical City, in coordination with the HR Training Department, will be starting a Health IT for IT Professionals (HIT4IT) Training Program.
This is a 14-week introductory course to the Basic Healthcare IT Concepts and Applications for IT graduates and professionals.
- To provide all participants of the course with the necessary knowledge, skills and experience in the fundamentals of Healthcare IT;
- To provide all participants opportunity to apply knowledge and skills in clinical systems analysis and software development and design;
- To prepare the trainees on how to work professionally in a corporate environment; and,
- To align the trainees to the corporate mission and vision of the hospital.
Target Participants or Trainees:
- IT professionals (programmers, systems analysts)
- (Optional) Graduate of any IT-related course
- One-on-one coaching and mentoring sessions;
- On-the-Job-Training; and,
- Practicum Work (Special Projects).
- Introduction (TMC and IT);
- Concepts in Healthcare Informatics;
- Computer Applications in Healthcare and Nursing;
- Principles of Healthcare Interoperability and Integration;
- Effective Software Development and IT Project Management; and,
- Systems Analysis, Design and Implementation for Clinical Applications.
Participants will be working with the TMC-IT Special Projects team. Special projects may include:
- Electronic Medical Record (Clinical Documentation);
- Clinical Data Repository;
- HL7 Integration;
- Electronic Medication Administration Record with Barcode;
- e-KARDEX Planning and Design;
- Hospital Information System Planning and Design; and,
- Outpatient Clinic Management System.
- Training is free. There is NO fee.
- Only 3-4 participants will be accepted.
- Expect programming tasks. Bring your own laptop.
- Target start date is on April 3, 2013. All three slots should be filled up.
- Participants will be interviewed for fit into program and interest in Health IT.
- Program Duration is a minimum of 336 hours (8 hours per day, 3 days a week, 14 weeks)
- Certificate of Attendance shall be given to the trainees who have satisfied all the requirements in the Practicum.
Interested and qualified participants should submit the necessary documents to the TMC Training and OD (TOD) Department and pass the initial interview:
- Letter of Interest specifying the participant’s intention to be part of the Health IT for IT Training Program,
- Updated copy of their resume with 1×1 or 2×2 size picture,
- (Optional) College Diploma or Training Certificate/s.
Shortlisted applicants will be forwarded to the IT Department for their final interview. If the participant passed the final interview, the IT Department shall forward its recommendation to the TOD Department for creation of a Memorandum of Agreement (MOA) between TMC and the participant to cover the training program.
Interested applicants may also send their application requirements to mbmuin(at)medicalcity.com.ph. I can forward the application to HR for initial screening before final interview with me and IT Department.
Questions, comments and suggestions are welcome.
- Cited research predicts telehealth to impact 1.8M patients worldwide by 2017.
- Telehealth is narrowly defined as remote patient monitoring in the article.
- Biggest driver is the need to lower healthcare cost.
- Telehealth is a growing field–and is here to stay.
- Hospitals and clinics should start looking into this service to extend their reach.
- Doctors should explore potential of this service to improve outcomes.
BMC Medical Informatics and Decision Making | Abstract | Does Googling for preconception care result in information consistent with international guidelines? A comparison of information found by Italian women of childbearing age and health professionals.
- Researchers googled for preconception/pre-natal information,
- They compared search results against international guidelines.
- Result: Not all information available on the Net match medically-approved guidelines.
Lessons learned and take-aways:
- Information across the Web does not yet reflect medical guidelines.
- Patients and health consumers should be advised against believing everything they read on the Net.
- Health providers should take more effort to disseminate correct information in their websites.
- Doctors should be prepared with correct information as some patients may come in with Googled notes that might not exactly be medically sound.
It’s the start of the year and we are in the middle of MANY planning sessions for our different Health IT projects. They include:
- EMR module for our Outpatient Clinics
- EMR module for our Wellness Center
- HL7 integration of Laboratory Information System
- HL7 integration of Radiology Information System
- Legacy data migration of existing systems into our Clinical Data Repository (CDR)
- API integration of legacy systems
- EMR module for Telemedicine setup in satellite clinics
This article made me write down reminders so we can avoid our previous mistakes in project planning. Let me share them with you.
- NEVER ever assume 100% allocation for your staff. Many IT staff work on multiple projects at a time. Don’t assign task timelines that require 1 person or team to be 100% focused. That almost always never happens.
- Don’t forget to include testing and bug-fixing into the plan. This is crucial when you do system integrations (HL7, XML) or data migrations. Testing and bug-fixing, from experience, eats up TOO much time in the project–but you can’t go live without doing them.
- ALWAYS work with VENDOR timelines. Sometimes we assume that vendors can give 100% allocation of their resources. They have other projects and clients. Be realistic.
- ALWAYS work with USER timelines. Availability of project stakeholders, team leaders and user groups vary–especially in a hospital environment. Make sure you don’t draft project plans and timelines without being realistic about their other obligations to patients, staff and hospital.
- If the ultimate goal or outcome is unclear, plan in iterations. Adopt the Agile Methodology–even if it isn’t software. We’ve used iterations (1st round, 2nd round, 3rd round, etc.) in the design of our work spaces, floor plans, furniture.
- If you lack the appropriate manpower for the project, put recruitment in the plan. This is fairly obvious.–but I’ve seen plans drawn up without people to do the specific tasks defined.
- Draft project overview statements and success criteria early on. Don’t wait until everyone is confused before you do the exercise of gaining “clarity of purpose”.
- Pencil in weekly (or regular) review meetings into the plan. Better to have these planned out early on so people can put them in their calendars.
- Don’t forget HARDWARE! Sometimes, project teams can be too focused on software development that they forget they need to make that system run on servers. Make sure to give ample time for ordering and delivery of needed hardware.
- Don’t let inexperienced people (or management) dictate timelines. Although some management deadlines are “doable but EXTREMELY challenging to execute”, some demands are plain impossible to meet. Challenge yourself and your team with timelines but never promise the impossible. It provides unnecessary mental anguish.
I’m sure there are more of these reminders. I can’t remember all.
Do you have your share of common HIT project planning mistakes? What were they?