Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!
Note: today’s first article was written by the CIO of an academic medical center that will move to Epic once the necessary approvals are in place (not yet announced). I suggested drafting some thoughts about why Epic is so successful in that market, even with hospitals that had no plans to replace their existing systems. I thought the perspective of a CIO in the middle of that decision would be interesting since it’s hard for the rest of us to understand how Epic can be so consistently successful, and therefore tend to blame unspecified “Epic Kool-Aid drinking” rather than the real differences between Epic and its competitors.
Why Epic? Why So Many Decisions to Deploy Epic?
By Thoughtful CIO
As a nation of healthcare delivery systems, we seem to be selecting Epic in record numbers. I’m told that nine of every 10 decision-makers are selecting Epic.
It is astounding, but it is also rather obvious. Epic has become the market choice for many of us. And like many market swings, the causes are many.
I’ve given it some thought. I fully expect that many will disagree. This is just one person’s opinion.
In some ways (I hope you can forgive the melodramatic root cause), I think our focus on Epic and the need for tight integration and simplification of our environments might relate to the upcoming 10th anniversary of September 11. We are longing for a return to a simpler time.
It has been ten years since the “world stopped turning.” I think many of us are carefully revisiting where we have been and what we have accomplished since that September day. It might not be deliberate, but I think it is real, nonetheless.
We all refocused on the “main thing” back in 2001. It may have been different for different industries, but in healthcare, we decided we were going to make a difference. And I think we meant it.
Sadly, in spite of much hard work, and many system deployments, we are not yet achieving safe, efficient, and effective healthcare to the degree we all had hoped.
Here is some thinking out loud.
- In a world where healthcare decisions and information flows are growing increasingly complicated and are conflicting, our care providers are overwhelmed with complexity, burdened by too much not-always-relevant information, and are often interrupt-driven as they attempt to make decisions. It feels like chaos because it is. It’s a difficult balancing act. Many of us are longing for a simpler and safer approach to the management of information. We haven’t yet found it, and we worry that it is hurting our patients and making it more difficult to be a care provider.
- Patient- and family-centered care is going to become even more critical in the world of individualized health and personalized medicine. This will require improved access to longitudinal patient records. It will necessarily involve and empower the patient to be an active member of the care team. It will soon be the only way to effectively and efficiently manage and allocate scarce resources. Targeted interventions and therapies will be the future of medicine, and information technology will be a critical component of the deal. But we are not yet delivering on the promise, in spite of many millions of dollars of investment.
- To deal with this complexity, chaos, and the critical focus on the patient-centeredness, we are focused on minimizing the burden on our care providers and our patients. We want to collect data once, at the source, in the most user-friendly way possible. We want our data collection to be the by-product of care, not an added responsibility. And we want it to be easy to do. We have not yet found a way to achieve these goals in a meaningful way, at least not consistently.
- Some current vendor-supplied solutions offer choices and options. They promise to be all things to all people. They rely heavily upon a provider-based organization to make wise decisions and “perfect decisions” in the midst of a very imperfect world. The decisions that must be made expect that there is clarity, when in fact there is not. We are not realizing increased productivity, lower costs, and more efficient care. In fact, many of our healthcare delivery systems are questioning the investments we have made and are not yet able to clearly define the benefits we had hoped to achieve.
- Many of us have experienced implementations that over-promised and under-delivered. We trusted our vendor partners and some of them failed us. We then we failed our user partners. The systems didn’t perform well, the vendor was unable to deliver the rich functionality that was promised, the product didn’t scale, the developer didn’t listen, etc. Everyone loses, and we were parties to the losses.
- Enter Judy Faulkner and Epic. There is no ambiguity! For more than 30 years, she has been crystal clear about her strategy and the strategy of Epic. The patient is at the center. The business of healthcare is about saving lives and managing information to support life-saving activities. No ambiguity. It’s about the basics, and she gets the basics right! From the beginning, what you see is what you get. No ambiguity.
- Judy Faulkner and Carl Dvorak treat everyone the same. No deep discounts, no development partners. We’re all in this together. There is no ambiguity.
- Judy and Carl have a healthy optimism about the future. They believe there are many opportunities we can leverage, but they never make a promise they can’t keep. They tell the truth. They do what they say they will do.
- Judy doesn’t offer to solve problems she can’t solve. She is completely transparent and tells the truth, both when it is popular and when it isn’t. No pretense. She doesn’t need to be liked. She has a product that works, that scales, and is fully integrated. There is no ambiguity.
- Judy also sells a product that works well. She provides the rules for how it must be implemented. Again, she eliminates the ambiguity. Follow the rules and everybody wins.
I’m not sure I’ve captured what I was hoping to capture. In summary, when I think of Epic, I think of a few words:
These are words I hope folks will use to describe the work we all do in healthcare IT.
What Providers Need to Know about Patient Engagement
By Donna Scott
Given all the talk these days about patient-centeredness, is there really change afoot? Will the US healthcare system of the future really be built around the needs of patients? Or is “patient-centered” just another buzzword which won’t quite survive the complexities, the political realities, and the multi-faceted stakeholders in the great healthcare reform debate?
Well, I have been called an “optimist,” so you can probably guess my opinion on the subject. Yes, I believe that we are truly at the crossroads of change in the healthcare system in the United States. In spite of the complexities and difficulties ahead of us, the desire to implement new ways of managing healthcare in this country has never been stronger.
Regardless of what you think about the future success of Accountable Care Organizations or Patient-centered Medical Homes, there appears to be widespread agreement that US healthcare delivery needs to shift from a quantity orientation to quality of care and better outcomes. And better patient outcomes will be enabled by a much higher level of patient engagement across the healthcare industry. This shift toward quality outcomes and patient engagement represents both an opportunity and a challenge for providers.
Because of this shift, a small group of patient engagement enthusiasts and industry pundits were recently asked by The Institute of Technology Transformation to write a paper for providers about the current state of patient engagement. The objective was to offer healthcare providers a summary of the latest research that exists about patient engagement and provide some key points for their consideration as they embark on the healthcare reform journey. The Top Ten Things You Need to Know about Engaging Patients is the result of our efforts. The paper can be accessed here.
In summary: there is a lot of good patient research out there that our group has synthesized into the following key ten considerations for providers:
- Providing Patient Education Online
- Interactive Online Dialogue
- Patient Segmentation
- Role of Caregivers
- Trust in Physicians
- Consumer Mobility
- Security and Privacy Concerns
- Leveraging Inexpensive Tools
- ROI of Patient Engagement
- Changing Care Models
In each of these ten areas, we briefly discuss the research and the key learnings which are relevant to providers. In addition, we include four key recommendations for practical action:
- Walk the talk: set specific patient engagement objectives and measure them
- Champion your hospital’s social media strategy and assure mobility as a key component
- Pay attention to caregivers and do your homework on patient demographics
- Consider HIT solutions that already incorporate patient access and engagement capabilities
For some progressive hospital administrators, this information will simply affirm what they are already doing. For the others, we hope it will spark ideas on how to take their patient engagement strategy to the next level. Because the need for more patient engagement in the U.S. healthcare system will impact all of us, sooner or later.
Donna Scott is leader of the Patient Engagement Action Group for the Institute of Health Technology Transformation and executive director of marketing strategy for RelayHealth.
Twitter, Dogs, and Healthcare
By Ronnie James Dio
I see a lot of dogs out in public these days. They’re everywhere. People bring them to Home Depot and into Starbucks. Sometimes they’re peeking out of purses.
I love dogs. I’d even go so far as to say I consider most dogs excellent judges of character. But I’m not wild about sharing my coffee and oatmeal at Starbucks with somebody’s dog right next to me. When I go to the grocery store, I don’t want to see a dog riding in the basket of the grocery cart.
I went to the dentist the other day. Guess who’s hanging out by the reception desk? You got it — a big black Lab. Named Elliot, by the way, which I consider to be a decidedly un-dogly name. The look in his eyes said, “I’m begging you, call me Fetcher.”
I want some boundaries is my point. Just give me a shopping experience without dogs.
Same goes for ubiquitous talk about social media. More specifically, Twitter. I really don’t care that Anderson Cooper of CNN on-air wants to tell me he’ll be tweeting during the broadcast. (I especially don’t like the word “tweeting,” while we’re coming clean with each other.)
Also, I don’t need software I use in my healthcare IT business to update Twitter with what I’m doing, as a contract management tool I have is dying to do for me. Just sent a contract out! Third one today!
I don’t say this thinking trade secrets could be disclosed. It’s much simpler: I’m just not that interesting.
And now that we have these two things on the table (too many dogs in public; I’m largely boring) I need to cover one more thing. I don’t find Twitter interesting or helpful for healthcare except, I’m sad to say, in a catastrophe such as an earthquake or tornado, where we actually learn things we couldn’t know otherwise.
When tornadoes strike or a tsunami hits, Twitter can be indispensable. It can become a strikingly important tool for healthcare, if only to inform others where help is needed. When we least expect it, a hula hoop becomes a vital messaging tool.
Otherwise, it’s the dog in Starbucks, the thing I can’t escape that I actually don’t dislike, but I want to pick and choose my interaction with it.
And just because there’s a tool that lets us share 140 characters of text with the world doesn’t mean it’s valuable. In the real world of healthcare, when things are not catastrophic, I’m arguing that Twitter is rarely helpful, and as parents can attest (via the attestation process) in the breezy “real” world teenagers move in, few have the slightest interest in Twitter. It interferes with their texting.
I have a very high professional focus on healthcare IT, so I typed in “healthcare IT” from the main Twitter screen. This popped up:
We r letting d Tfare issue overshadow d aim of the damn lunch. It was a forum where issues of light, good healthcare / education were discussed.
Besides the fact that I find the phrase “damn lunch” funny, I have no idea what the post means, but I’ll bet a quarter it’s right at 140 characters. I’m also pretty sure there is no such thing as “light, good healthcare,” and I’m positive that you should be able to find “healthcare IT” in context when using an ever-present tool for social media.
So I put to you a simple question. Outside of emergencies or catastrophes, when does Twitter actually benefit healthcare? Who is helped, and how?
I’m wide open to learning something here, but please answer in 140 characters or less. I’ll be back in touch after I take my dog to church, then out for a damn lunch.