Interesting piece of news here: U.S. Coast Guard pulls out of Epic EHR contract, forcing return to paper records

In my talks, I sometimes ask the audience to give the reasons why EHR failures are pretty common. Many would cite technology challenges, workflow problems, politics, etc.

But, for me, one of the biggest “contributors” of Health IT failures is because “paper is always an option”.

In the healthcare setting, paper is always a “reliable” back up. Reliable is all in quotes because–paper being unreliable is one of the main reasons we’re implementing an EHR.

When implementing an EHR, nobody ever “burns that paper bridge”. It’s always nice to have that Plan B. But what if you don’t have that option? What if you have no choice but to always move forward with computerization?

Sometimes it’s good exercise to scare ourselves into a corner once in a while.

The College of Healthcare Information Management Executives (CHIME) started a national challenge to come up with a solution for a National Patient ID system. CHIME is the professional organization for Chief Information Officers and other senior healthcare IT leaders in the US.

The Challenge:

Ensure 100% accuracy of every patient’s health info to reduce preventable medical errors and eliminate unnecessary hospital costs/resources.

Source: CHIME National Patient ID Challenge

We have the same set of challenges and problems here in the Philippines. Many hospital IT systems contain multiple instances of the same patient, e.g. Mike Muin, Michael Muin.

Some Asian countries, e.g. Singapore and Malaysia, have a National ID system. This helps keep distinct and manageable patient identities inside electronic medical records. Citizens use their national IDs while foreigners use their passports.

In the Philippines, because we don’t have a National ID system, solutions focus more on mitigation and cure. We rely on matching algorithms and patient merging techniques to manage multiple patient identities inside IT systems.

If we were to use a National Patient ID system, what should it be? PhilHealth? SSS? Phone numbers?

Should we have our own national challenge?


Here’s a new and very informative Webinar from the YouTube channel of AMD Telemedicine.

It starts with a demo of their Telemedicine technology.

Then, it continues with the sharing of experiences, tips and lessons learned from 3 installations. Some of their discussions will be more apt for US-based scenarios, e.g. reimbursements, but most of the sharing will have global appeal as they talk about patient experiences, clinical workflows, and provider experiences.

It’s about an hour long so bookmark it until you have time to watch it.




As a Hospital IT Consultant or Healthcare CIO, I deal with IT vendors all the time. Here’s my take on working well with your IT vendors.

Two General Categories of Vendors

If the hospital follows the long-term strategy of “Build + Buy”, IT vendors often fall under two general categories:

  1. Software Development: These include companies that provide contractual employees, consultancy for in-house software development or outsourced application development. This engagement is for custom-built software such as hospital-specific clinical and research applications.
  2. Product/Service Providers: These include vendors of administrative software, e.g. financial and inventory systems, and ancillary systems, e.g. PACS and laboratory information systems. Others may provide services for hardware support and software acquisitions.

Working Relationship

When working with IT vendors, I find it best for the hospital management and/or IT department to do the following:

  • Treat them as partners. Make it easy for them to help you solve your problems.
  • Make them accountable for their product–AND their promises. Honesty, integrity and truthfulness are essential ingredients for an excellent working relationship.
  • Do not believe all their promises. Even with a good working relationship, understand that they are still in the business of selling.
  • Pay on time. Help the company thrive.
  • Make referrals. Help the company grow.
  • Give feedback of their services. Help the company get better.
  • Do not adapt their vision for your company. Come up with your own. Despite their good intentions, you know your company much better.
  • Identify success and/or acceptance criteria during development or implementation. These items should be specific and measurable. This helps everyone look at the same direction.

Choosing an IT Vendor

Document and understand your hospital and project needs before going through the process of vendor evaluation. It is easy to be distracted by ‘product or service peripherals’. Come up with a standard for evaluation and stick to it.

Beyond that, here are some qualities I look for in the company and in its people:

  • Excellent listening skills: They’re not only selling a product/service, they hear what you need and are sincere in helping you solve your problems.
  • Experience, knowledge and skills: They should know their product and their customers. They should know what they are doing.
  • Willing to learn: I admire organizations who invest in their people. They constantly strive to be better.
  • Ability to walk away from a project: I like vendors who can say ‘No’ to a project. It shows honesty, integrity and an understanding of their company’s or product’s limitations and capabilities. The opposite of this would be vendors who promise to have or do everything.
  • Accept defeat graciously: When other vendors are chosen, they still stick around and help with other projects. It reflects an organizational culture that wants to build relationships and not just a client base.

No healthcare organization is an island. Having the right IT partners can help the organization succeed in its process improvement, modernization and computerization efforts. The key is to choose wisely and maintain excellent working relationships.

These are just from my own limited experience. I’m sure there are more—and better—recommendations out there.

What’s your experience with IT vendors? Are they good or bad? How do you deal with the bad ones? What are your recommendations? Let me hear from you.

Many organizations mistake project management as nothing more than project coordination. And many IT projects fail because of this misconception.

Project management is not just an activity—it is a core skill of effective management.  Project managers (PMs) are NOT administrative clerks of meeting agendas, project calendars and schedules of deliverables. They should take on leadership roles and drive the pace of the project.

Here’s my top 3 key ingredients for effective project management:

  1. Accountability for Failure.
  2. Effective Decisions.
  3. Management of Outside Input.

Accountability for failure

It is said that success has many fathers but failure is an orphan. Effective project managers know that true accountability is being accountable not only for project success but also for project failure.

If this is clear from the start, few would volunteer to start or manage projects just for the ‘distinction’ of becoming project managers. Effective PMs know they cannot play the blame game at the end of failed projects.

Effective decisions

Project managers should have the commensurate authority to make decisions for specific details and tasks of the project. But authority is just the beginning. PMs should also make effective decisions.

Effective decisions should be both timely and actionable. The output of every decision should be a realistic action plan that is shared with the project team. Effective PMs know that the progress of the project is not determined by activities in the Gantt chart but by decisions made for the project.

Management of outside input

Effective PMs understand that many tasks and deliverables are beyond their team’s control. The bigger the project, the more groups involved. And input from these people are prerequisites for many project activities.

The PM will have to do a lot of ‘C’s: Communicate, Coordinate, Control.

Here’s a short list of tips to help manage outside input:

  • Identify deliverables as concrete as possible.
  • Make deliverables or task list public. Share with project stakeholders.
  • Get—and document—commitments from outside groups.
  • Do quick follow-ups or reminders prior to delivery dates.
  • Hold groups accountable for deadlines. Report frequent delays to group superior.
  • Confirm completion of tasks and deliverables as positive feedback.

If you notice, my top 3 ingredients tackle important management areas:

  1. Self – Get a true sense of accountability
  2. Internal/Project Team – Effective decisions drive effective teams
  3. External Teams – Find ways to manage things beyond your control



I’m sure there are more tips out there to be more effective at project management. What tips can you share to be more effective in project management? What habits, skills or characteristics do effective project managers have?