Happy Earth Day – Healthcare’s Green Initiatives

Earth DayCaring for our environment should be everyone’s responsibility. My Grandfather was what he called a ‘Forestry Consultant” and focused on reforestation in the 1970s and the 1980s. He founded a
National Park in the southern Indian city of Bangalore my family’s home town where he was very interested in the cultivation and use of bamboo for use in everyday life. The ability for us to think of ways use less plastic and have more biodegradable products will give future generations an opportunity to live a better life.

When I first heard about Earth Day (and bought a T-Shirt with that on it back in the 90s), it didn’t have as much meaning to me as it does now. As the world’s population grows and we need to think about how we can better utilize our limited resources to nourish and clothe the people of the world, we need to think about better conservation methods. Healthcare is also not immune to this, though going green in Healthcare IT is not a straight forward process. One way that healthcare has been better at conservation is the implementation and use of electronic health records, the biggest Go Green initiative ever by healthcare provider organizations. Tele-Health initiatives means that now, people in rural populations or anywhere for that matter, do not have to drive to a specific location for things such as specialist referrals and can cut gas emissions and improve population health. Data centers have leveraged the concept of server virtualization and reducing the carbon footprint of those data centers and also reducing hardware costs and power consumption. (Don’t forget to join us at our CSO HIMSS Spring Conference focused on mHealth and Tele-Health. Click here to see the agenda and register for the event – Not to be missed)

I’ll take this opportunity again to wish everyone a very Happy Earth Day!

The Wrap: Healthcare’s Look Back at 2014

Looking back on 2014As we look in the rear view mirror back on 2014, the year that was supposed to change our coding and billing systems, we see that ICD-10 dominated the news with it’s postponement in April and CMS’ subsequent new date of October 1st, 2015. Over the last few weeks though, I’ve heard rumors of yet another delay, this time due to the new political climate in Washington, D.C. These rumors are unsubstantiated, so I would keep them as such. I would record it as a risk to the program for those seeking to restart their ICD-10 initiatives.

Healthcare provider and payer organizations were in “shock and awe” (shocked and many people saying “awww”) at the same time, and high number of provider organizations deciding to postpone their programs indefinitely until the new date was announced and many just restarting the programs either late in the year or planning on doing so in the beginning of the new year, 2015.

The mission of provider IT organizations changed. Just as it was in the pre and post-Y2k days, organizations now wanted to get actual intelligence or analytics from the large systems that they had implemented at such great cost. We came full circle and Analytics started coming to the forefront during the year and it matured after all of the interest, talk and presentations  of Big Data, Business Intelligence and Analytics over the last few years. Leveraging actual data for case studies that I know of this year on Population Health Management and better response times in the ED.

In a recent article in Clinical Innovation and Technology, it was reported that ” as of November 2014, 11,478 eligible professionals and 840 hospitals have attested to Meaningful Use Stage 2. In total, 15,481 new EPs and 221 new hospitals have attested in 2014″. The healthcare provider ecosystem was able to move forward despite some inertia at the beginning of the year.

Many organizations also realized that their infrastructure needed to be updated with projects such as XP to Windows 7 migration; something that needed to occur due to the end support in April by Microsoft of their well known Microsoft XP Operating System.

Consumer health devices starting to get mainstream traction with products like Fitbit and Google Glass starting to look at possible mHealth applications for providers in the future.

The vision and ‘utopia’ of an Interoperable Healthcare ecosystem received a major boost with The Office of the National Coordinator for Health Information Technology releasing it’s “10-Year Vision to Achieve An Interoperable Health IT Infrastructure” by 2024. This would be a baseline for future infrastructure development across the United States and possibly even a starting point for world leadership in healthcare systems and infrastructure interoperability.

What a year it has been and we have so much yet to come in 2015 and beyond.

We don’t “Lobby” in Healthcare IT, we “Advocate”

As someone who grew up in other countries before becoming a naturalized American, there’s always been some kind of fascination when it comes to what is called “lobbying” in the United States. I’ve never been able to understand it as it always seems that it goes against the grain of what I’ve always thought of the United States through history books and the Founding Fathers, whom I so admire for their simple vision that has overcome the tests of time. Yet, hiring professional lobbyists in the United States is perfectly legal and healthcare has been leveraging this legal loophole for sometime now. Just this year as an example, lobbying has come into the news through the change in the regulatory date for ICD-10 from October 1st, 2014 to October 1st, 2015. Most believe that this was the result of pressure from care delivery professionals that wanted more time to get their act together (I for one was against this).

Recently, it was reported in “Modern Healthcare” (September 10th, 2014) that Epic retained a lobbyist and as it was reported the filing said that it was “to educate members of Congress on the interoperability of Epic’s healthcare information technology.”

Last week, HIMSS delegates from across the country had their yearly visit to Washington D.C. for their HIMSS Policy Summit, held during National Health IT week where (as reported by Healthcare IT News) HIMSS had certain asks of the nation’s representatives, which were:

  • Minimize disruption in our nation’s health delivery system emanating from federally mandated health IT program changes.
  • Fund the National Coordinator for Health IT to achieve interoperability, improve clinical quality and ensure patient privacy and safety.
  • Expand telehealth services to improve patient access and outcomes and decrease healthcare costs.

The role of politics and healthcare will remain inextricably tied to one another. As we continue to move through this paradigm shift, these areas will ultimately focus on the future of our country’s care delivery and outcomes and the way that we, the patient, will receive our care.

Mobile Health Security. It’s finally here!

Let me check my phone and get back to you. I’m sure everyone knows it’s so much more than a phone now. It’s an alarm in the morning, the main form of media that you read with your first cup of coffee; your organizer as you see what you have in store for you during the day and your recorder of memories that you will treasure for a lifetime. With everything happening on a mobile device; from taking pictures of checks to deposit in a bank to reviewing details of your office visit in your medical record app, the question about security of your mobile device in a healthcare setting was bound to be raised.

BYOD policies have been developed over the last few years in order to take into account the loss or theft of devices in a healthcare setting and the consequences they have for a care delivery organization. The ability to auto wipe devices after a certain number of tries is a necessity and care providers may not like the thought of their device losing all of it’s data, but in terms of what the risks of continuing to have that information on the device and the fact that 4 character or digit passwords could be breached after 9,999 attempts is something that care organizations must have a mitigation plan in place. Too many times, the headlines talk about data breaches and the possible compromise of hundreds, if not thousands of medical records due to a provider organization not properly planning for such loss of devices; mobile or otherwise.

Secure messaging as well comes into this environment. There are many organizations now that need to leverage the benefits of secure text messages between the provider and patient and between providers as well. The ability to have secure and confirmed delivery, the data behind it to show how many patients leveraged this form of communication, the audit chain of the messages and last but not least, compliance with HIPAA is what secure messaging communication requires to overcome the regulatory and practice challenges at healthcare provider organizations, with the HIPAA Omnibus rule from September 2013 also added to that regulatory mix. The ability to be more in tune with your patients through this form of communication and be able to engage faster with them brings positive strides to patient engagement metrics.

Ultimately, being able to provide great patient care through technological advances such as practical and timely mobile health solutions is what healthcare information technology teams should collaboratively strive to accomplish.

What do you mean top priority? Everything is #1 on the list.

A phrase often heard in the halls of an IT Department for a healthcare provider. With Meaningful Use Stage 2, ICD-10, technology upgrades and updates (XP to Win7 anyone?), break-fix, and migration of new clinical build, IT departments are constantly challenged with more and more operational priorities than anytime in their department’s past. How is executive leadership supposed to decide what their priorities are when everything is mandated and operations feels that they have just given IT millions of dollars to implement this EHR that was supposed to be the panacea for the disease of inefficiency and lack of interoperability?

We actually have to support and maintain this new system? We need to make sure that the new system can interface with the other clinical systems that we have across the organization and be able to update interfaces, update the system when we need to transition to ICD-10? We thought this wasn’t going to need more money, more people and additional storage space in the data center. Do we really need that new mobile application? I don’t use my phone to access my EMR so why would a patient want to engage us that way?

Many organizations across the country have had to change the way they think. Operations and IT need to realize that they are now connected even more closely ‘at the hip’. Everything is so inextricably linked to technology now that it is difficult, if not impossible to distance yourself from operational decision making without information technology being involved.

Geo-fencing’s role in preventive and e-health care

As healthcare changes, providers are trying more and more to grab the attention of their local and regional populations. One way of doing that is through geo-fencing. A geo-fence can be a predefined set of boundaries, like inpatient or outpatient boundaries. When you walk into a hospital, say for a diabetes appointment, the hospital wants to be able to push information to your smart phone telling you about seminars that may be useful for preventive care.

In an article published in Technorati titled “Google Bets On Geo-Fencing” in May of 2013, it talks about when Philips announced that it was partnering with Apple on a smart LED light bulb that featured geo-fencing technologies and that the “Hue” lighting system will allows it’s users to control wireless-enabled LED light bulbs inside their homes with an iOS app. Most interesting of all is how Philips is utilizing geo-fencing technology by allowing lights to turn on or off depending on the location of an individual.

Both patients and Care givers also have the ability through a vibrate, text or email ‘alert’ to assist long term care patients by knowing their whereabouts if the patient steps outside a certain boundary for care through a geo-fence.

Keep your eyes open for geo-fencing capabilities at a healthcare facility near you when your smart phone gets connected to your healthcare provider’s network. A boon also for healthcare marketing careers.