Readers Write 8/13/08

Siemens Medical Solutions Layoff Rumors

From The Walrus: “After years of making ugly PowerPoint presentations, ignoring to the customer voice, and mainly keeping themselves busy with internal fights and not much more, Siemens Medical Solutions, Malvern PA has started the dreaded massive layoffs. 480 people have lost their jobs this week out of a team of 1100 So-Aryan developers. And this is just the beginning … What happened to all those ‘world class leaders?”

From Azkaban: “It’s no rumor. Siemens Med laid off around 350 in Malvern, and about 250 in Bangalore who were working on Soarian Clinicals. Lots of senior people let go in Malvern. Feel free to speculate on what this means for the future.”

From Bestürzt: “About 400 people were laid-off today at Siemens in Malvern, PA.”

Note: I e-mailed a Siemens spokesperson to confirm or deny and received no response, so this should be taken as nothing more than a (widely reported) unconfirmed rumor. Still, the parent company announced barely a month ago that it would be axing 17,000 workers.

Planning to Fill the “Career Is Over (CIO)” Position
By Art Vandelay

At least once I month, an article, blog post, vendor or consultant makes reference to CIO meaning "Career Is Over." This is happening at the same time that many organizations are realizing their leadership positions are graying. Some are not only graying in the leadership ranks, but also in their key technical positions. One organization realized that over 2/3 of their leadership and 3/4 of their technical positions supporting their major application were within five to 10 years of retirement.

The only way to ensure a flow of qualified candidates exists for the CIO position is to prepare the staff and to fill the pipeline. This post is about preparing the staff. A future post will be about filling the pipeline. Staff need to be prepared for what the job is now and what the job and our departments should be.

From my view of the world, some organizations have begun to reexamine their career ladders and formally defined succession plans. Fewer have provided leadership training or formally defined mentors with time carved out for key leaders to mentor staff. The fewest have defined cross-department leadership rotation programs. These are all traditional human resources and organization development techniques.

To ensure the best prepared candidates, I’d recommend each of the techniques contain the following. Career ladders need to encourage the ability to work horizontally across rungs to gain knowledge of other disciplines within your department and in the organization. Succession plans need to groom the staff for the position rather than just aging them in their departmental barrels without guidance. Mentor programs need to be supported by executives who want to participate and these executives need the time to participate. The mentors should include IS and non-IS executives to provide alignment with the business. Also realize that not everyone is good mentor and protégé material. Cross-department rotations need to include real opportunities to run projects and operations.

All of this needs to be done while taking into account individual learning styles. Some people learn by observation, some by doing, and some by discussion and reflection. One size doesn’t fit all. It also needs to take into account how the workforce is changing. Expectations of and tolerance for telecommuting, communication styles and techniques, diversity in race, ethnicity and age, along with work-life balance expectations, are elements of the changing workforce.

If someone creates, implements, and continues to operate such a program, let me know. That is a place I want to work. This type of a program would deliver aligned and well-rounded leaders. It would also foster mutual respect between IS and the business. I am planting the seeds of this in my own organization. I hope they grow.

Pharmacy Barcoding
By Mort R. Pescle

You said it right. The technology most vendors are peddling would not have helped those 17 Texas babies who were overdosed with heparin when pharmacy staff put the wrong drug dose in their IVs.

Most errors that harm patients are caused by IVs. Most of those that don’t get caught are due to mistakes in mixing, not mistakes in ordering or hanging. The huge investments in CPOE and bedside barcoding systems haven’t addressed the majority of potential patient harm even in the unusual situations where those systems are actually used as planned without workarounds or deficiencies. Minimally trained pharmacy technicians put clear drug solutions in clear IV solutions, so the only check is to compare the containers they said they used with what the label says.

The fix involves barcoding inside the pharmacy walls. Barcode what is received from vendors to make sure nothing was shipped incorrectly. Barcode again when packages are broken down to stock shelves in the IV room to make sure drugs are put in the right place (which they aren’t in many cases, surprisingly). Barcode again when mixing the IV to compare what was ordered against what was chosen to mix.

Unlike bedside barcoding, this is really not very hard. The pharmacy system “knows” what items were intended. Each of those can have a list of acceptable NDC numbers defined. Scan the label against the product and it either matches or it doesn’t (with some exceptions due to imprecise ordering when employees aren’t necessarily aware of the exact packages that will be used to prepare the IV).

No technology can detect having the wrong dose drawn up of the right drug, but catching wrong drug IV mistakes should be a piece of cake, at least if there’s any money left that wasn’t squandered on unused CPOE systems.

Open Software Review -  WebVista
By The PACS Designer

With all the talk about the VistA EMR System and how it is languishing in the healthcare space, TPD thought it would be good to review an open source solution from ClearHealth called WebVista.

ClearHealth has taken the powerful VistA EMR system which powers the Veterans Administration health network and modernized it. With added, seamless, scheduling and billing WebVista offers the only fully comprehensive VistA based system in a cost-effective, Web 2.0 package. Utilize all of the capabilities from a standard web browser.

ClearHealth’s WebVista system has many examples of forms and dashboards on their website which can be accessed at:

http://www.clear-health.com/content/view/41/51/

After clicking on an example, you can zoom the document by clicking once on it for easy reading.  Since there are quite a few to view, it is recommended that you proceed through each one to get a better perspective of its usefulness to you.

ClearHealth is still looking for more Beta testers, so if you want to help, feel free to contact them to further the VistA movement.

You  can contact ClearHealth at info@clear-health.com or call 877-571-7679.  Also, you can go to the Open Enterprise Platform for more on ClearHealth at:

http://www.op-en.org/

While there is a reluctance to use the VistA EMR system by the DoD and other government agencies, it is worthwhile to use the open source path to perhaps make VistA more usable by other healthcare organizations around the world through enhancements to WebVista.