Reinventing Clinical Decision Support
In our latest book,Reinventing Clinical Decision Support: Data Analytics, Artificial Intelligence, and Diagnostic Reasoning, Paul Cerrato and I explore the promise of artificial intelligence and machine learning for improving clinicians ’ ability to make more informed diagnostic and therapeutic decisions. Here’s an excerpt from Chapter 2:“AI is a once-in-a-generation transformative technology. As such, expect its impact to be on the scale of the advent of electricity or the Internet,” says Jean-Claude Saghbini, Wolters Kluwer Health.(1)“Artificial intelligence and machine learning are set to t...
Source: Life as a Healthcare CIO - April 24, 2020 Category: Information Technology Source Type: blogs

A COVID update
I realize that my blog post frequency has diminished during COVID.  Writing time has been redirected to thenational COVID-19 coalition and its 14 workgroups:AnalyticsModeling& SimulationHealth Systems and Clinical SMESupply ChainTelehealthTestingICU and Mechanical VentilationCOVID-19 Data Standardization (mCoVD = Minimal COVID-19 Viable Dataset)Non-Pharmaceutical InterventionsOptimization of Clinical Therapeutics/ProtocolsData Storage and SourceDis/MisinformationPrivacy AdvisoryContact TracingBelow is a description of this week's highlightsa. Critical Shortages of Personal Protective Equipment (PPE)Worked wit...
Source: Life as a Healthcare CIO - April 18, 2020 Category: Information Technology Source Type: blogs

Coming Together to Save Lives
The following is a post from the members of theCOVID-19 Healthcare Coalition , #C19Coalition co-chaired by  Dr. Jay Schnitzer, Chief Medical and Technology Officer at MITRE  @MITREcorp who directs initiatives in health/life sciences and Dr. John Halamka @jhalamka, President of Mayo Clinic Platform who leads a portfolio of platform businesses focused on transforming health.-------Pandemics thrive in confusion.Not because diseases like COVID-19 have intent, but because the lack of a focused response makes the spread of disease so much easier.Pandemics stress our healthcare delivery system. We ar...
Source: Life as a Healthcare CIO - March 22, 2020 Category: Information Technology Source Type: blogs

Unity Farm Sanctuary and COVID Planning
You might think a farm sanctuary doesn't need cyber-liability insurance (we do because we track social security numbers associated with donations).  You may not think that a Farm Sanctuary needs a comprehensive COVID plan.We need a plan for five reasons1.  We are a community gathering point for over 100 volunteers and hundreds of people taking enrichment classes including Yoga, Tai Chi, Meditation, Beekeeping, and Council on Aging activities.2.  We are an employer with full time and part time workers3.  We are accountable for the health of more than 250 creatures.  Without humans, these creatu...
Source: Life as a Healthcare CIO - March 21, 2020 Category: Information Technology Source Type: blogs

Bringing Out the Best in Us
In the upcoming week you'll see numerous writings about national private sector efforts to enhance COVID response, communication, and collaboration.As part of doing this work, one of my colleagues noted that the she's seen many recent examples of current events bringing out the best in people.   There's a willingness to help, a eagerness to volunteer, and a sense of belonging by banding together for a common cause.   Yes there are stories about hoarding toilet paper and purell, but those are minor distractions compared to the good things happening around us.Here are examples of what I've seen in th...
Source: Life as a Healthcare CIO - March 21, 2020 Category: Information Technology Source Type: blogs

What's a Platform Go Live?
As we plan our go-lives for the Mayo Clinic Platform, we recently discussed how best to measure what constitutes a go-live.First, let's review what Platform thinking (technology, policy, people and process) can do for an organization.*Facilitates collaborations and partnerships with external entities (i.e. participants on the Platform benefit from the presence of other participants)*Connects assets (data, algorithms, expertise) with customers in ethical, privacy protecting ways*Supports the development of ideas into products that may be licensed, spun out, or sold as services*Has turnkey technology and policy approaches th...
Source: Life as a Healthcare CIO - March 7, 2020 Category: Information Technology Source Type: blogs

What is the Architecture of a Modern Platform?
Platform businesses require technology that promotes interoperability and scalability.  For those who live in platform companies day-to-day, my thinking below may sound obvious, but for those who are thinking about a cloud journey, the list of technologies below may be helpful.Storage and compute functionality in the cloud enables agility via " infrastructure as code " products such asTerraform.   Terraform enables virtual server spin up on demand within applications to provision and manage any cloud, infrastructure, or service.  Each cloud provider has strengths.   Customers li...
Source: Life as a Healthcare CIO - February 26, 2020 Category: Information Technology Source Type: blogs

The Future of Elder Care
Last weekend I moderated an amazing group of presenters for Harvard Business School's 17th Annual Healthcare Conference, debating the future of elder care throughout the world.Discussants wereGeoff Price - Oak Street Health, Chief Operating OfficerSusan Diamond - Humana, President of Home SolutionsNeil Wagle - Devoted Health, Chief Medical Officer We started with a statement of the problem - in many countries such as Japan, the Nordics, Germany, Italy, and the United States, societies are rapidly aging.  Birth rates are declining.   Costs are rising and access to clinicians is becoming more challen...
Source: Life as a Healthcare CIO - February 14, 2020 Category: Information Technology Source Type: blogs

Innovation at Work
Over the past 40 years I've worked in a variety of workplace settings, each appropriately serving its intended purpose. I did not appreciate how much a workspace influences my productivity and mood until I starting working at Mayo. My new role focuses on convening stakeholders and facilitating discussion.   A supportive workspace is transformational.In my mid-teens, I worked in shared office space at TRW (a predecessor company to Raytheon) with large metal desks, filing cabinets and fluorescent tube lightingIn my late teens, I founded a company in a basement and worked at a drafting table next to a bedIn my ...
Source: Life as a Healthcare CIO - February 4, 2020 Category: Information Technology Source Type: blogs

Innovation at Home
This is the first of a two part series that describes where I live and where I work at Mayo Clinic.  To me, life and work are inseparably intertwined.   You cannot have a productive work life if your home life is unstable.   You cannot have a balanced home life if your work life is unstable.   When I decided to work at Mayo, my wife and I agreed that we would live in Massachusetts running Unity Farm Sanctuary but I would work in Rochester/Jacksonville/Scottsdale Sunday night through Thursday night. Over the past month, I've organized a life in Minnesota, maximizing my well-being...
Source: Life as a Healthcare CIO - February 4, 2020 Category: Information Technology Source Type: blogs

Moving Complex Systems Toward a Goal
I recently told several of my Mayo colleagues that I'm an outsider who has landed in a new environment where the degree of collaboration, dialog, and friendly debate is amazing.   The following a kind of guest blog, started byDr. Michael Joyner, who is also a writer He wrote to a number of us"Great paper written by chairman of bank of England in middle of financial crisis.  Pertinent to anyone interested in nudging complex systems towards a goal. "  Below are the responses:Let ’s move away from risk prediction a bit and apply these concepts to our world.  The world of...
Source: Life as a Healthcare CIO - January 30, 2020 Category: Information Technology Source Type: blogs

Advice for Aspiring CMIOs
Recently, my colleague Steve Peters, chief medical information officer, Mayo Clinic, and I discussed our life experiences as CMIOs.  We talked about how the role has evolved along with changing technology and the transition to nearly universal adoption of electronic health records by large health centers. I asked Steve to share his insights on'what makes a great CMIO in 2020'and captured his thoughts for you." I have thought about the'post-EHR'CMIO as most large centers and hospitals have moved on from the initial implementation.   Here are a few thoughts:1.    Serves as the pri...
Source: Life as a Healthcare CIO - January 22, 2020 Category: Information Technology Source Type: blogs

A New Model for Sharing Insights While Protecting Privacy
Last week at JP Morgan, Mayo Clinic announced a new collaboration withnference that I would describe as " Cloud-hosted, de-identified, federated learning in which the tools are brought to the data instead of sending data to the tools " ThisHealthleaders article describes it well. Here's a broad overview.  Let's start with 3 containers. The first container is controlled by Mayo Clinic, holds identified data, and has one purpose - the development and optimization of de-identification algorithms. Selected data scientists, who are accountable to Mayo Clinic, are asked to help with algorithms via t...
Source: Life as a Healthcare CIO - January 21, 2020 Category: Information Technology Source Type: blogs

Dispatch from JP Morgan
 Although I've been attending healthcare and technology conferences for more than 40 years (yes, I attended Comdex in 1979), but until this week had never attended the JP Morgan Healthcare Conference. The conference gathers 60,000 investors, innovators, and providers for four days to plan the next year ’s path for healthcare and building relationships that will foster future innovation. I have extensive experience attending HIMSS , which has similar numbers, but only a small fraction actually attend the main the JP Morgan Healthcare Conference.  My Mayo colleagues and I pr...
Source: Life as a Healthcare CIO - January 16, 2020 Category: Information Technology Source Type: blogs

How Does a Platform Reduce Barriers to Innovation?
One of our Mayo Clinic Platform team, Emily Wampfler, recently forwarded me an overview ofMIT's Platform conferenceRead the Barclay's piece.  It notes that 55,000 people changed focus from product support to a platform service line orientation, remarkably enhancing business opportunities.Few organizations in healthcare have created a Platform which connects data producers and consumers, standardizing security, enhancing reliability and accelerating agility.   What is the urgency to embrace a Platform approach to healthcare?   I believe a Platform strategy is the best way to reduce ba...
Source: Life as a Healthcare CIO - January 10, 2020 Category: Information Technology Source Type: blogs

Week One
My new role as president of the Mayo Clinic Platform began officially on January 1, 2020.   I was selected for the role in late November and  volunteered time in December to better understand the technology, people and processes of Mayo Clinic.   What will I do in my first weeks at Mayo?  Listen to my colleagues, customers, and staff. I learned a valuable lesson in 1998 when I first became a CIO.  I was seeing patients on a 2pm-2am Emergency Department shift when my Motorola flip phone rang at midnight.   The conversation went something like this  &...
Source: Life as a Healthcare CIO - January 4, 2020 Category: Information Technology Source Type: blogs

A Look Back at 2019
I've always been an optimist.  I believe humans are basically good and that the nice guy will win eventually.After traveling 400,000 miles to 40 countries in 2019, helping government, academia, and industry, my view of the world has not changed.Despite our focus on the negative 24x7 news cycle, 2019 has been thebest year for humanity in history.My best memories, looking back at 2019:*Serving the Gates Foundation in South Africa and Northern India.  Experiencing the rollout of technology enabled platforms that reduced HIV disease burden and improved diagnosis/treatment of tuberculosis.*Working with mayors and...
Source: Life as a Healthcare CIO - December 31, 2019 Category: Information Technology Source Type: blogs

Reinventing CDS Requires Humility in the Face of Overwhelming Complexity
Paul Cerrato and I have created a new book,Reinventing Clinical Decision Support, our first to be published about Platform thinking.  Although it is being published during my tenure at Mayo Clinic, it is not endorsed by Mayo Clinic and represents the personal opinions of Paul and me.  Below is the preface.In our last book, on mobile health(1),  we wrote about the power of words such as cynicism, optimism, and transformation. Another word with powerful connotations is misdiagnosis. To a patient whose condition remains undetected, it is a source of frustration and anger. To a physician or nurse who has be...
Source: Life as a Healthcare CIO - December 30, 2019 Category: Information Technology Source Type: blogs

An Engineering Eye for the Tie Buying Guy
At the Mayo Clinic, patients always come first.  In my few days of volunteering, I picked up on some subtle ways that the culture supports patient-centric values.  Office areas are very utilitarian while patient care areas are well furnished and decorated.  Everyone is professionally dressed, regardless of their role.  For me, that means wearing a tie every day (and retiring my Dr. Martens).  Over the past 20 years, I've worn engineered black clothing in my travels around the world.  I've not worn a tie and long ago donated all the ties from my youth.  Admitt...
Source: Life as a Healthcare CIO - December 27, 2019 Category: Information Technology Source Type: blogs

Mayo Clinic's First Platform
In my first few days volunteering at Mayo Clinic to meet colleagues, establish collaborations, and better understand the amazing patient services Mayo provides throughout world, I had the opportunity to tour the historic Plummer Building with Douglas Holtan,  chair of the Department of Facilities and Support Services.  Immediately, I realized the building is Mayo's first platform.In my last post, I described a platform as a way to use knowledge and technology to facilitate connections, creating value in the process.How could a building be a platform?To understand that, you need to understand the past, provided to...
Source: Life as a Healthcare CIO - December 19, 2019 Category: Information Technology Source Type: blogs

What is a Platform?
This month I'll deliver several keynote addresses.  In my presentations, I'll use terms such as platform enterprises, platform thinking, and platform strategy.  But what is a platform?Is it just a collection of standards?  If so,  is a USB flash drive a platform, since I can transfer a file from my Chromebook to someone else's Macbook using it, in a low effort, low cost fashion?Not exactly —in the USB example, there is no agreement about what file types are preferred, what data those files may contain and what security controls will be used to protect the integrity and privacy of the data.In ...
Source: Life as a Healthcare CIO - December 12, 2019 Category: Information Technology Source Type: blogs

What's Next?
After nearly 25 years in Boston, I'm beginning a new journey at Mayo Clinic in the role of president, Mayo Clinic Platform.  Many colleagues have asked me about the transition.  First, I have profound thanks for my mentors and collaborators in Boston.  I could easily fill an entire blog post with the names of hundreds of people who worked with me since 1996 on cloud services, mobile applications, machine learning, connected devices, and data standards.Those innovations  made a positive impact on many people.   At Mayo, I believe I can scale the lessons learned in Boston to stakeholde...
Source: Life as a Healthcare CIO - December 4, 2019 Category: Information Technology Source Type: blogs

Remote Patient Monitoring and Self-Responsibility
At HIMSS next week, I'll be doing 5 presentations about the future of healthcare IT, focusing on patient directed data exchange, internet of things, and telemedicine.   Remote patient monitoring,  which combines all three, will be increasingly important.Remote patient monitoring can take numerous forms,  and the evidence supporting these tools is mixed. Here ’s another excerpt from our new book—The Transformative Power of Mobile Medicine—co-authored by Paul Cerrato that dives into the issues.  For those interested in reading the entire book, the publisher is offering a deep d...
Source: Life as a Healthcare CIO - February 7, 2019 Category: Information Technology Source Type: blogs

What's Next for Healthcare?
Today I had the honor of keynoting at a major announcement from Apple, Aetna and CVS/Caremark.  I'd summarize the message as " Digital Health has arrived and is now mainstream, fully embraced by the major stakeholders in the healthcare ecosystem. "Here's the upshot.The history of healthcare and payment has been risk pool based and focused on paying for sickness.The future belongs to wellness, personalization, and a team-based approach to keeping you healthy in your home. The announcement of Aetna Attain, a collaboration of Aetna, CVS/Caremark, and Apple, is based on a few key ideas:1.  Persona...
Source: Life as a Healthcare CIO - January 30, 2019 Category: Information Technology Source Type: blogs

Embracing ChromeOS (and the cloud mindset required)
2019 will bring many changes.  After more than 20 years as a Chief Information Officer, I will pivot to lead innovation as part of the senior leadership team for the newly mergedBeth Israel Lahey Health on March 1, 2019.  Here's theBoston Business Journal articleabout it.My innovation role will focus on 5 areas:A front door/liaison to government/industry/academia for digital health collaboration at Beth Israel Lahey HealthExploring new technologies, especially those arising from outside healthcare, to assess their role in provider/patient/payer workflowMentoring startups and internal faculty seeking to ...
Source: Life as a Healthcare CIO - January 22, 2019 Category: Information Technology Source Type: blogs

Exploring the Connected Medical Home
Over the past few weeks, I've been exploring the combination of internet of things, artificial intelligence, and ambient listening with a focus on how these technologies might improve care management, patient/family navigation of the health system, and wellness.Google, Apple, and Amazon all have ecosystems that include the functionality I'm writing about.  Purely because I'm spending January investigating the Android/ChromeOS environment, my first exploration has been with Google products.   I'll explore Apple next.Here's my test bed:Unity Farm Sanctuary heating and cooling is controlled by Nest Thermostats....
Source: Life as a Healthcare CIO - January 17, 2019 Category: Information Technology Source Type: blogs

Dispatch from India
I spent last week in Bihar, an area of Northern India near Nepal.  The best way to describe the journey is in pictures.Our small team visited villages along the Ganges to the east of Patna, tracing the path of patients from seeking care to diagnosis to treatment to compliance to wellness.  We met with patients, providers, field officers (think of them as care managers), chemists (pharmacists), and labs.   Here's what we experienced:The villages had hand pumped water supplies, electricity and 4G cellular connections.  Cows and goats were a part of many households.A unique telemedicine program f...
Source: Life as a Healthcare CIO - January 15, 2019 Category: Information Technology Source Type: blogs

Choosing Effective, Sticky Health Apps (Part 2)
In a blog post last week, I shared an excerpt from the new book that Paul Cerrato and I just completed,The Transformative Power of Mobile Medicine. Here is a second excerpt from Chapter 3,  “Exploring the Strengths and Weaknesses of Mobile Health Apps.”Even patients who are fully engaged in their own care still need access to medical apps they can trust. The IQVIA Institute for Human Data Science has performed a detailed analysis of the clinical evidence supporting mobile health apps, rating their maturity and relative quality. Its rating scale places a single observational study near the bottom of th...
Source: Life as a Healthcare CIO - January 10, 2019 Category: Information Technology Source Type: blogs

The Meaning of Life (as a CIO)
As I approach 60 and reflect on over 40 years in the healthcare IT industry I sometimes feel that I ’ve transitioned from a rogue upstart to the leader of the status quo - always about to be disrupted. I’m no longer a trouble maker, I calm the troubled healthcare technology waters.  If I ’m not careful, that could mean I’ll become a rate limiting step to radical change since I’ve been shaped by a lifetime of experience that started with punch cards, paper tape, and Fortran.The themes I ’ll write about twice a week in 2019 will be about exploring new technology around the world and i...
Source: Life as a Healthcare CIO - January 8, 2019 Category: Information Technology Source Type: blogs

Choosing Effective, Sticky Health Apps
In arecent blog post, I talked about the new book that Paul Cerrato and I just completed, The Transformative Power of Mobile Medicine. In that post, we shared the Preface to the book in the hope that it might pique readers ’ interest in mobile health. What follows is an excerpt from Chapter 3, “Exploring the Strengths and Weaknesses of Mobile Health Apps.” Choosing Effective, Sticky Health AppsEven healthcare providers who see the need for innovative mobile apps still face numerous obstacles. Given the human tendency to seek the path of least resistance, identifying the most effective, &ldq...
Source: Life as a Healthcare CIO - January 3, 2019 Category: Information Technology Source Type: blogs

Embracing Android
Happy New Year!  I'll be posting blog entries twice a week in 2019, describing my experiences in the healthcare IT innovation economy and international digital health.Throughout my history in the industry, I ’ve tested many emerging technologies and tried to predict future winners.  Here's a CIO magazine article from 2007 in which I replaced my computing platforms each month to rigorously testWindows vs. Linux vs. OSXIn the late 2000's, I felt that Microsoft had lost its agility and focused on adding features that few people wanted at the expense of usability.  I switched to Apple products because the ...
Source: Life as a Healthcare CIO - January 2, 2019 Category: Information Technology Source Type: blogs

The Power of Mobile Health
2018 was a very busy year, requiring extensive international travel —I racked up more than 400,000 miles this fall.  But now that my schedule is a bit more manageable, I plan to start posting again to “Life as a Healthcare CIO”. In addition to my travels to China, Japan, Australia and a long list of other countries, I managed to find the time to work with my esteemed co-author Paul Cerrato on our third book, The Transformative Power of Mobile Medicine. We wanted to share the Preface with readers and have included it below, along with a link to Elsevier ’s web site for those interested in readin...
Source: Life as a Healthcare CIO - December 14, 2018 Category: Information Technology Source Type: blogs

Embracing the New, New Thing
My life has been devoted to the pursuit of innovation - attempting to embrace new ideas and new technologies before the path ahead is completely clear.  Admittedly, I have not leveraged social media to the extent I should have.For a decade, I ’ve posted blogs and for many years wrote lengthy posts every day. In recent months, as my writing has focused onbooks,articles, and the newBlockchain in Healthcare Today peer reviewed journal, I ’ve written fewer blog posts.In an age where the news cycle is 24 hours (or less), I ’ve found that people appreciate more frequent, shorter communications, so I&r...
Source: Life as a Healthcare CIO - February 6, 2018 Category: Information Technology Source Type: blogs

My Technology Christmas List for 2017
Although this week will be lighter because of the holidays, the work never ends.  At the Sanctuary, I'm using our Terex skid steer and its attachments (consensus method from forums suggests the " blade " to create windrows then the snowblower attachment to move the windrows. Light snow - blade only). Although we did not receive more than a few inches of snow, we are getting early bitter cold, so snow will not be melting for the next 10 days. It was a very white Christmas!Here's my technology Christmas list for 2017The Sanctuary now usesoutdoor Nest cameras so that we can remotely view the animals t...
Source: Life as a Healthcare CIO - December 26, 2017 Category: Information Technology Source Type: blogs

Another Dispatch from a Broken Healthcare System
I'm working on a series of " Dispatches from a Broken Healthcare System " based on my personal experience as a care navigator.  I've already written about a frustratingcare management experienceToday's blog is a guest post from Amy Stiner, a healthcare expert and single mom from the Pacific Northwest.  She reflects below on what should be a simple task - transferring records between institutions in the age of Meaningful Use." My name is Amy Stiner and my healthcare consulting career has taken my 6-year old son, my mother, and me progressively across the country. Over the course of Grant &...
Source: Life as a Healthcare CIO - November 30, 2017 Category: Information Technology Source Type: blogs

Dispatch From South Africa
My blog readers must think I've abandoned them over the past few weeks.  I apologize for the whirlwind of October and November.  With the BIDMC-Lahey merger planning and the new cloud hosted Meditech go lives of my day job, plus the usual Fall conference commitments, and my new work with the Gates Foundation, blogging has fallen behind.The Gates Foundation has a bold plan for Africa - unifying the health records of the continent using biometrics, simple phone apps, and a highly resilient low bandwidth cloud that includes data integrity components based on blockchain.Here's the use case - patients with HIV ar...
Source: Life as a Healthcare CIO - November 21, 2017 Category: Information Technology Source Type: blogs

Unity Farm and Unity Farm Sanctuary Update for November 2017
Starting next month, my daughter Lara will take charge of our instagram, Facebook, and Twitter feeds, providing daily updates about the Farm and Sanctuary.  As we approach winter 2017, we can officially declare that the farm and sanctuary are now fully built and we're transitioning to daily operations.  We have over 250 animals at this point, all kept healthy, warm and fed every day.  Here's a summary of the past month, as told in pictures.From mid October to early November, the swamp maples, oaks, and poplar take on shades of crimson and bright yellow, turning Unity Lane into the kind road less travele...
Source: Life as a Healthcare CIO - November 20, 2017 Category: Information Technology Source Type: blogs

Don't Let Things Slip Away From You
Kathy has written this guest post, about the unexpected death of a friend." Please don ’t let things slip away from you:first steps,first kiss,first real vacation …first time you know that something is not quite right in your body.I discovered yesterday that someone about my age whom I have known for at least 15 years had passed away in September. I had seen her once during the summer.I was told by her colleague that about a year and a half ago, she noticed leaking from one breast. Her coworkers persisted in asking about the situation and she then told them it was just an infection from a cat scratch. It ...
Source: Life as a Healthcare CIO - October 26, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - September 2017
I ’m on a flight to New Zealand as part of my international government service. The 26 hour commute means that even with just two days of meetings in Auckland, I will be gone from the farm for 5 days.I spent Saturday morning cleaning paddocks, emptying manure carts, packing hay bins, filling water troughs, and doing the final repairs/maintenance that will ensure the farm/sanctuary can thrive for a few days while I ’m gone. What happens at the sanctuary over a typical week? Numerous volunteers spend time with animals, providing companionship, exercise and socializationHorse experts bond with Amber...
Source: Life as a Healthcare CIO - September 17, 2017 Category: Information Technology Source Type: blogs

We Can Improve Care Management
As a physician and CIO, I ’m quick to spot inefficiencies in healthcare workflow. More importantly, as the care navigator for my family, I have extensive firsthand experience with patient facing processes.My wife ’s cancer treatment, my father’s end of life care, and my own recent primary hypertension diagnosis taught me how we can do better.Last week, when my wife received a rejection in coverage letter from Harvard Pilgrim/Caremark, it highlighted the imperative we have to improve care management workflow in the US.Since completing her estrogen positive, progesterone positive, HER2 negative breast ...
Source: Life as a Healthcare CIO - September 12, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - August 2017
I ’ve put down the pitchfork and shovel, returning to the keyboard to update everyone about our Sanctuary progress.  Here ’s what’s happened over the past few weeks.As Kathy wrote on Facebook on July 25, Pippin, our 30 year old Welsh Pony passed away from cancer.  His last few months included daily play with three other ponies, walks in the woods, and generous servings of grain/treats.  He was the centerpiece of our horse work at the sanctuary and we miss him every day.  He ’s buried on a hill covered with oaks overlooking the barnyard marked by a large flat stone.The s...
Source: Life as a Healthcare CIO - August 18, 2017 Category: Information Technology Source Type: blogs

Unity Farm and Sanctuary Guest Post
Over the past few weeks I've been writing a few journal articles and finishing a book, so my blog posts have waned.  They will start again soon.  In the meantime, my mother is visiting and here is her guest post.Dagmar Halamka's farm notes from August 4,2017 and August 5, 2017.The beauty here is infinite - wildflowers everywhere, bee colonies in colorful hives, gushing fountains in ponds with swimming ducks and geese and vast amounts of greenery because of the frequent rain. 60 acres of enchanted forest that even " House and Garden " magazine could not duplicate surround the farm. Ro...
Source: Life as a Healthcare CIO - August 6, 2017 Category: Information Technology Source Type: blogs

Reflections on the US HIT Policy Trajectory
I ’m in China this week, meeting with government, academia, and industry leaders in Guangzhou, Shenzhen, Beijing, Shanghai, and Suzhou.  The twelve hour time difference means that I can work a day in China, followed by a day in Boston.  For the next 7 days, I ’ll truly be living on both sides of the planet.I recently delivered this policy update about the key developments in healthcare IT policy and sentiment over the past 90 days.I ’ve not written a specific summary of the recently released Quality Patient Program proposed rule which provides the detailed regulatory guidance...
Source: Life as a Healthcare CIO - July 7, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - First Week of July 2017
Admittedly, the pace of my writing has slowed this Summer since each day is filled with a combination of IT work, mentoring, and keeping 60 acres of farm/sanctuary running smoothly.  How ’s it all going? Our trajectory is good.So much of what we ’re doing at the farm/sanctuary is improvisation that we have no choice but to create a vision and accept ambiguity on the daily journey.We received a request to adopt a house pig - Rue, who ’s 80 pounds at 4 years old and extremely well behaved. We ’ve been socializing her with the other pigs and thus far, all is proceeding as expec...
Source: Life as a Healthcare CIO - July 3, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Second Week of June 2017
Star the Donkey arrived at the Sanctuary last week and she ’s living with the goats, serving as a livestock guardian.  She ’s 18 years old (donkeys live to 35) is about 100 pounds overweight.  We ’ll be restricting her diet, giving her daily exercise, and provide intensive veterinary care until her weight normalizes.  I expect that will take a year or two.  Her first vet visit and farrier (hoof) work will be this week.Honey the chicken develop wheezing this week and we ’ve isolated her from the flock.  Although she has intermittent breathing issues, she &...
Source: Life as a Healthcare CIO - June 8, 2017 Category: Information Technology Source Type: blogs

What ’s Next for Electronic Health Records?
With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement(including personal liability for the CEO, CMO and COO), many stakeholders are wondering what ’s next for EHRs.Clearly the industry is in a state of transition.  eCW will be distracted by its 5 year corporate integrity agreement.  AthenaHealth will have to focus on theactivist investors at Elliott Management  who now own 10% of the company and have a track record of changing management/preparing companies for sale.  As mergers and acquisitions result in more enterprise solutions, Epic (and to ...
Source: Life as a Healthcare CIO - June 1, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - 4th week of May 2017
Spring ’s warmth and rain is accelerating our plant and mushroom growth such that every day is a balance between agricultural management and sanctuary development activities like trail building as pictured below.  The stone bridge you see was built in the early 1800's.The adventuresome project of last weekend was replacing the 20 year old heating oil tanks in the Sanctuary.  The seams were weeping and oil was accumulating on the sides of the tanks.  I recently heard a nightmarish story about an oil delivery of 500 gallons into a 250 gallon tank that had a newly ruptured seam.  With new tanks,...
Source: Life as a Healthcare CIO - May 25, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Third Week of May 2017
In case it seems that my posting frequency has dropped, it ’s a combination of a hectic spring farming/sanctuary schedule and writing requests from outside organizations.  For my views on the recent cybersecurity/ransomware events see thePBS Newshour blog.Unity Farm Sanctuary work clothes have arrived in our closets.  This was my wife ’s idea to identify mentors and experienced volunteers on the property.  We have so many visitors every day who are walking the trails, visiting the animals, and offering to help that we need to separate those with experience from those who are new to the sanctuary....
Source: Life as a Healthcare CIO - May 18, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - First Week of May 2017
We continue to work on the forests and trails surrounding the Unity property to create a community resource. The map below shows the current status of the land (water is in blue) - 18 trails, 10 bridges, 3 ponds, and 5 streams.  We ’re clearing invasive non-native plants, removing decades of scrap metal/pottery/plastic midden piles, and taken down unstable dead trees that are a safety issue. With every passing week, the land becomes more and more accessible. Every time I go to the rural foundation meadow, I find it filled with wild turkeys, deer, raptors, coyotes, and rabbits.  Our goal is to...
Source: Life as a Healthcare CIO - May 4, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Fifth Week of April 2017
Several folks have contacted me, wondering why the pace of my blog posting has slowed a bit in April.  Don ’t worry - all is well on the farm and sanctuary, it’s just spring planting, maintenance, and trail building time.  The snow has melted, the weather is mild and the plants/animals need more attention that ever.Here ’s what we’ve been up to over the past two weeks.  The adjacent landowner to Unity Farm and Sanctuary is the Sherborn Rural Land Foundation and they ’ve asked for our help maintaining their protected land.  I ’ve expanded our trail system to ...
Source: Life as a Healthcare CIO - April 27, 2017 Category: Information Technology Source Type: blogs