EPtalk by Dr. Jayne 5/23/24

I’m reporting this week from the AMIA Clinical Informatics Conference in beautiful downtown Minneapolis. Although I usually prefer to be in the great outdoors, I must say I’ve enjoyed being in the city and having zero cicadas flying in my face compared to what I’m used to at home. AMIA wins the best badge ribbons title hands down and has something to meet everyone’s needs for pop culture references.

The conference has been filled with great sessions and plenty of networking opportunities. It’s been nice to see people who I rarely see in person and to make new contacts. Of all the AMIA meetings, this one focuses the most on applied informatics. I’ve already jotted down several pages of helpful tips for upcoming projects. 

Speaking of jotting notes, I’m glad that the included AMIA pen writes smoothly, because it’s been a long time since I’ve taken notes by hand. I appreciate the workshop sessions that have had table setups because it makes it much easier to manage your notes or laptop as well as any snacks or drinks you might have with you.

I also heard some great quotes that were worth making note of. One of my favorites so far is, “People who are into tech aren’t always into communication.” This resonates with anyone who has encountered detailed instructions for electronic devices that don’t take into account the fact that end users aren’t necessarily engineers. Another quote in the patient safety realm was, “Pharmacists don’t break rules, so if they’re doing it, you know you’ve run off the rails.” I was also excited to hear two people at the poster session and reception discussing something they had read about in HIStalk, which always makes my day.

One conversation between sessions included anecdotal reports about what is going on inside Ascension hospitals during their ransomware-inflicted downtime. Someone with inside knowledge mentioned a situation where younger members of the staff were unable to read the cursive handwriting used by some clinicians. My local public schools stopped teaching cursive around 2008 or so, causing some entertaining moments at family birthday parties as the youngsters try to read their grandparents’ handwriting in greeting cards. Cursive or not, physician handwriting has been the butt of jokes for decades, and poor penmanship can result in significant medical errors. Something for hospital and healthcare delivery organization leaders to consider as they’re reviewing and revising their downtime plans.

Back to Ascension, the organization is providing updates on a state-specific basis. I noted these nuggets from the Wisconsin section: Ascension retail pharmacies remain unable to fill prescriptions and patients have been asked to “bring notes on symptoms and a list of current medications, including prescription numbers or bottles.”

Lawsuits related to potential HIPAA violations have been filed on behalf of Ascension patients in the US District Courts of the Northern District of Illinois, Western District of Texas, and Eastern District of Missouri. I couldn’t find information on the other two, but the one from Texas appears to be a class action. Buckle up, Ascension, it’s going to be a wild ride.

As far as cyberattacks and downtime are concerned, the Workgroup for Electronic Data Interchange (WEDI) sent an eight-page letter to the Department of Health and Human Services highlighting the vulnerability of the US healthcare system and the need for greater oversight and improved business continuity planning. It asks for a new Office of National Cybersecurity Policy led by a “Cyber Policy Czar” and a National Health Care Cyber Fire Drill Week. Regarding the latter, organizations would be charged to work not only with internal systems, but with “critical trading partners” to test systems and define contingency plans. I’m happy to dust off my high-visibility Incident Command vest for the occasion, I just need to find some snappy shoes to go with it.

From Hybrid Curmudgeon: “Re: Dell flagging employees that aren’t coming back to the office as much as they’re expected to. How degrading.” Apparently, Dell is aggregating the data from VPN usage and in-person badge swipes to assign color codes for employees to make it clear how much they are working in the office versus from a remote location. Workers are expected to be in-person for 39 days each quarter. Starting this month, workers will receive weekly updates via the company’s HR platform and will be assigned a color (green, yellow, or red) based on respective time in the office (regular, some, limited). Top performers with a consistent presence in the office will be flagged in blue. I’ve worked in organizations where a variety of indicators are used to identify employees to be placed on the block for the next round of cuts, and this is just one more piece of data to add to those matrices. Nine box talent grids, anyone?

Speaking of talent, one of the hot topics among CMIO types this week was the challenge of retaining talented clinical informatics staffers when they’re partnered with physicians who need to move across the country either for training or for improved job prospects. Allowing staff to work remotely would be an easy fix, but I understand the reluctance of health systems to want to deal with multi-state employment law and payroll regulations. I still find it humorous that these same systems will outsource their IT departments, sometimes outside the US, but won’t make accommodations to retain successful team members.

I also heard some discussion about the number of burned-out physicians who are trying to cross into clinical informatics as a “way out” and the political implications of having them appear in the hiring process. It sounds like some are claiming that they’re “in clinical informatics” because they’ve used an EHR in their career, despite the lack of deeper knowledge of healthcare information systems or the processes and governance needed to sustain them.

My outbound flight for the conference had a mechanical issue which led to a delay of about an hour. Although passengers weren’t thrilled, I didn’t hear a lot of people voicing concern about connections, so that’s a good thing. At least it wasn’t an issue like the one that occurred recently when a United flight from Zurich to Chicago had to divert when a passenger’s laptop was swallowed up by a business class seat. The crew was unable to retrieve it, and due to the risk of fire with lithium-ion batteries, the flight landed in Ireland. The ensuing chain of events, including the inability to access the laptop from anywhere but through the cargo hold, led to a crew time out and an overnight stay for passengers.

What’s the strangest maintenance delay you’ve experienced on a flight? Leave a comment or email me.

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