Beyond Medical Informatics

For 2012, these are SOME the things we will be working on here at The Medical City:

Telemedicine

We are looking at improving and expanding the healthcare services of The Medical City including the satellite clinics and provincial hospitals (TMC Iloilo and TMC Angeles).

MID OMRI

OMRI is the document management system for our medical records. This is were scanned images of previous patient charts are stored and managed by the Medical Information Department (MID). We plan to improve the interface, features and security of the program to allow access into the system from the various nursing units and clinical areas.

ICARUS Medication Management

The ICARUS system is our medication management system that uses barcode technology. It is deployed in all nursing units. Full compliance is a bit challenging. Poor Wi-fi coverage for the handheld units also need to be addressed. This year, ICARUS will have to be "re-implemented" to get more units to adopt the system and increase compliance.

Once ICARUS is "re-implemented", we can work with NSO for more IT projects that improve nursing workflows.

Laboratory Information System

Plans for this year include fully implementing the Microbio, Blood Bank and Histo-Cyto modules. We may need to look into building another system for Blood Bank to handle donor management.

HL7 integration of the system with SHAMAN (ADT and OMG) and PRIME (ORU) is also planned for this year.

PRIME Phase 1 Roll out

PRIME stands for Patient Records and Integrated Medical Exchange. It is our clinical data repository and electronic medical records platform. We just finished development December 2011 and we plan to roll this out in the ambulatory units within the year. First pilot implementation is at Wellness. Wellness should be working with the system by February 2012.

Roll out of the clinical documentation feature to the other ambulatory units should commence by mid-Feb or March 2012.

PRIME Phase 2 Development

There is still more to be done with PRIME. We have just touched the surface for what we need in clinical documentation and electronic medical records. Phase 2 will incorporate the clinical research agenda of the hospital.

PRIME Results Integration

We need to integrate the following systems with each other: SHAMAN, MUSE (ECG System), Laboratory Information System (LIS), OMRI, ICARUS Medication Management and PRIME.

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This blog post is to help disseminate information among doctors and clinicians of TMC.

As always, I welcome comments, suggestions and questions. I also encourage active participation of clinical units in our efforts.

Thanks!

It’s been over a month since I last written for the blog.

My life as a CIO has been very busy. The past few weeks much more so. Some of my recent activities (I’ll write about them soon) include:

• Continuing development and design of TMC PRIME—the EMR platform we are developing.
• TMC Quality Fair Week where we had a booth that featured TMC PRIME.
• Implementation of Google Apps—Yes, TMC is now on GMail!
• Initial wrap-up of 2011 projects for Year-To-Date IT accomplishments (in preparation for budget planning).
• Initial project planning for next year’s budget.
• Initial brainstorming for restructuring of IT Department.

The last one has been in my mind for several months now—probably since I started work as CIO. I found our IT organizational structure to be rigid and unwieldy. I had a hard time responding to critical IT requirements and situations. Projects were not managed or monitored well. Some projects slip through the cracks of proper implementation.

Then it dawned on me. For several years, the main IT project was the hospital information system (SHAMAN). This system started out small but has since become the workhorse of hospital operations. And the IT department was almost exclusively organized around this application—to the detriment of other IT projects.

I shared this with my IT managers:

We have an IT department that is structured to support a single software.

That can’t be. We need to change that. We have other IT projects aside from SHAMAN, like:

• HL7 Integration Platform
• Clinical Data Repository Platform
• Clinical Documentation Platform
• Business Intelligence
• Document Management Systems

Our users also have other IT plans like:

• Improved charge capturing using mobile devices
• Improved medication management
• Online surveys and patient feedback forms
• Research and patient registries

So, I pose this challenge to my IT management team.

Let’s build an IT organization that supports the whole organization including the network of clinics and hospitals we serve.

It will not be easy. Our initial thoughts focus on the following areas:

• Strengthen the IT management team with focus on strategic planning, initiatives and relationship-building.
• Build project management and systems analysis core competencies among the staff.
• Build technical core competencies for the core technologies used.
• If possible, outsource some IT services, e.g. technical support, specialized programming.

Let’s hope we succeed.

Next year will be an exciting year!

Dr. John Halamka, in his blog, describes some of the ways healthcare is different from other industries—and these things help explain why Healthcare IT is more challenging.

It’s a two part post: Healthcare is Different and Healthcare is Different Part II.

Here are some of the ones I found interesting:

• Workforce: Many doctors are not hospital employees. It’s not easy to get compliance.
• Funding: Healthcare has complex funding and payment structures. This makes it challenging to fund IT innovations.
• Product Standardization: Clinical quality is hard to standardize. Many results are based on patient response and not all patients respond the same.
• Domain expertise: It takes years to be an expert in a particular field.

He ends his first post with an optimistic outlook of the challenges facing Healthcare IT. He ends his second post with this:

My personal goal is to build software and workflow processes that make the complex seem easy, reducing the burden on providers so that they can focus on what’s really important, the patient.   That’s why the work for a Healthcare CIO will never be done.

I have to agree completely.

Dr. John Halamka shares his top 10 leadership principles for surviving as a CIO via Life as a Healthcare CIO: A Customer Emotion Dashboard.

10. Select your change and what not to change
9. Identify those who will lose
8. Acknowledge their loss
7. Over Communicate
6. Be Honest and Consistent
5. Consensus is not essential
4. Embrace conflict
3. Focus on your detractors
2. The last two minutes of the meeting are the most important
1. You cannot please everyone

Our IT department will have to face daunting challenges in 2011. Our IT services need to transform and improve. Tips No. 10 and No. 7 are important.

Once all strategic and operational plans are set, I will over-communicate like hell.

“Over-communicate, over-engage, over-inform.” That’s my new motto.

Let me share some good news: I am now the Chief Information Officer (CIO) for The Medical City (TMC) and its network of hospitals and clinics.

I started just over a month ago—and I really have my work cut out for me.

TMC is not unique in its healthcare IT challenges. Integration is still a major goal. The hospital information system needs enhancements and optimization. Correct alignment of IT projects with business strategy is a constant effort.

My immediate to-do list includes:

• draft an integration and EMR roadmap
• propose an effective clinical IT governance process
• build a professional IT organization
• transform IT infrastructure and services to support the TMC network

Sounds easy, right?

The road will be challenging but I welcome the adventure.

Wish me luck!

I found a great online resource: IT Execs Release Guidebook on E-Health Records Implementation – CIO.com.

The College of Healthcare Information Management Executives released a guidebook for CIOs and other IT managers with tips and first-hand experiences in implementing electronic health records in order to meet government “meaningful use” standards.

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The publication, The CIO’s Guide to Implementing EHRs in the HITECH Era, includes best practices and steps health-care organizations should take to successfully implement EMRs, from the initial planning through the final documentation of results.

The guidebook is free for the public and can be downloaded here.

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting these past few weeks.

From CMIO.net:

• IBM report: CIOs spur provider innovation (Excerpt below)

Based on the responses of the CIOs, IBM determined that “successful” CIOs blend three pairs of roles:

• An Insightful Visionary and an Able Pragmatist;
• A Savvy Value Creator and a Relentless Cost Cutter; and
• A Collaborative Business Leader and an Inspiring IT Manager.

Also from CMIO.net:

• AIM: Collaborative effort needed to advance health IT
• Panel: Health IT professional shortfall underestimated

From Dr. John Halamka:

• A self-disinfecting keyboard. Expensive but might be very effective for infection control.

From FierceHealthIT:

• Stimulus creates huge demand for HIT professionals. Health IT is now a boom profession and industry in the US. How about here in RP?
• Internet use transforming patient-provider relationships. Some patients here can be more Net-savvy than many of our doctors. How will this affect patient-doctor relationships and the consultation process? I’ve already heard of stories where patients bring in print-outs of online medical news and updates–and sometimes the doctor is not as up-to-date as he’d want.

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Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!