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 1, 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 20, 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 25, 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 17, 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 - May 31, 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

The Dark Side of E-commerce
As I mentioned in arecent post, Amazon has focused on the convenience of the customer instead of the convenience of their business.  Yesterday ’sNew York Times highlighted the trend for the hotel industry to do the same.In my post, I lamented that some industries including old school industrial companies and healthcare have not widely adopted customer focused technologies.  To their credit, Marvin Windows followed up with me and promised to accelerate their automation efforts.  I was impressed.However, all is not completely rosy in the transformation from brick and mortar to e-commerce.In an ...
Source: Life as a Healthcare CIO - April 26, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - First Week of April 2017
In North America, Easter and Thanksgiving are traditionally associated with eating ham and turkey.   You can imagine that a vegan sanctuary is very popular with creatures who want want to avoid being eaten.This week, we had the great turkeychautauqua .  Every wild turkey in the local forests assembled at Unity Farm Sanctuary for an afternoon of companionship, dancing and gentle conversation.  To put this photo in context, it ’s taken from the sanctuary loft - about a football field away from the turkeys. There are 17 turkeys in just this view. Yes, the Tom turkey in the middle of th...
Source: Life as a Healthcare CIO - April 6, 2017 Category: Information Technology Source Type: blogs

A Cautionary Tale for Healthcare
During my CIO career, I ’ve worked on a few Harvard Business School case studies and I’ve had the “joy” of presenting my failures to Harvard Business school students for over a decade.I enjoy telling stories and inevitably the cases I teach are about turning lemons into lemonade.In this post, I ’d like to tell a story about a recent experience withMarvin Windows and lessons learned that apply to healthcare.  I know that sounds odd, but hear me out.At Unity Farm and Sanctuary I ’m the proud owner of about 100 Marvin windows from the 1990’s.  All are still functional but in...
Source: Life as a Healthcare CIO - April 5, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Fifth Week of March 2017
We continue to refine the sanctuary buildings, prepare the new animal care areas, and keep our creatures healthy.Sweetie, our 18 year old Welsh Pony developed a sore on her right lip.  Using my human medicine training I inspected it for abscess formation and drained it, while also applying local antibiotics.  It did not heal this week, so we asked the horse vet to take a look.  It turns out that when horses have tooth abscesses in the lower jaw, they develop drainage tracts in their lips.  Tooth abscesses in the upper jaw drain into the sinuses and out the nose.  She ’s now on ...
Source: Life as a Healthcare CIO - March 30, 2017 Category: Information Technology Source Type: blogs

Early Experiences with Ambient Listening Devices (Alexa and Google Home)
BIDMC has a long tradition of testing speculative technologies with the notion that breakthroughs often require tolerance for failure.  For example, we ’ve embraced blockchain in healthcare because we believe public ledgers have promise to unify medical records across institutions.Over the past few months, we ’ve developed healthcare applications for Alexa, Amazon’s ambient listening device that combines natural language processing and easy to use application program interfaces.  We have also tried Google Home.Here ’s our experience thus far.1. We ’ve used Alexa in a pilot ...
Source: Life as a Healthcare CIO - March 29, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Fourth Week of March 2017
It ’s officially Spring and although the weather is cold and snowy, the anticipation of warmer weather means that Unity Farm Sanctuary is more active than ever.This week, a local young woman purchased our goose eggs and made traditional Ukrainian Pysanky Easter eggs.  We were impressed.The owners of Penny Blossom, the Yorkshire pig living at the sanctuary for a year, brought us empty wire cable spools.  The goats are jumping from spool to spool, having a great time.This week, we finished creating the last bedroom at the Sanctuary using a 1760 ’s bed we found in Plymouth.  It was not designed...
Source: Life as a Healthcare CIO - March 23, 2017 Category: Information Technology Source Type: blogs

Embracing Innovation
I ’ve written several posts over the past two years about the need for innovation in healthcare IT - deploying self-developed apps, leveraging third party cloud hosted functions, and embracing the internet of things.I ’ve previously discussed establishing a center for innovation.  In preparation,  I ’ve worked on innovative projects in industry accelerators, academic collaborations, and government sponsored hack-a-thons.What has worked?1. I ’ve learned that it is very important to make innovation a part of the day to day work inside an organization.  Creating change externally an...
Source: Life as a Healthcare CIO - March 22, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Third Week of March 2017
With every passing day, Unity Farm Sanctuary increases its capacity to host public educational sessions, retreats, and events.  Our first few months were focused on the historical Unity Hall building.  As you ’ll see in the photographs below, we’ve made substantial progress.  The next few months will be focused on expanding our capacity to give " forever homes " to animals in our community.  A design, which works for just about every species we ’ll encounter, is done.  By May it will be a reality.Here ’s a view of the rooms of the Sanctuary, all...
Source: Life as a Healthcare CIO - March 16, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Second Week of March 2017
When you run a sanctuary, you need to be agile.  We received a message that we had until 1pm to rescue a heritage turkey or he would be eaten.  We drove the Unity Farm van to pick him up and within 2 hours he was living at Unity Farm Sanctuary.  Meet Palmer, a 2 year oldRoyal Palm turkey He ’s social, friendly, and very interactive.  He gets along with all the other birds, the dogs, and pigs. I was able to pick him up and move him into the barnyard without a struggle.  Although we now have over 150 birds, we have little experience with turkeys.  We let Palmer choose h...
Source: Life as a Healthcare CIO - March 10, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Fourth week of February 2017
In New England we often say that if you do not like the weather, wait 5 minutes.  The high this week at Unity Farm Sanctuary was 70F and the low was 5F.  We ’ve had blankets on the horses overnight then removed them at dawn to prevent overheating.  The flowers are blooming now but have frozen solid over cold nights. I fear that our apple crop will be diminished since the young buds will be damaged by killing frosts.  There ’s not much I can do to battle an unexpected cold snap.The cold means that every creature - wild and domestic - struggles to stay warm.  Turkeys and deer are com...
Source: Life as a Healthcare CIO - March 2, 2017 Category: Information Technology Source Type: blogs

Next Steps for the National Healthcare IT agenda
At HIMSS, I listened carefully to payers, providers, patients, developers, and researchers.  Below is a distillation of what I heard from thousands of stakeholders.It is not partisan and does not criticize the work of any person in industry, government or academia.  It reflects the lessons learned from the past 20 years of healthcare IT implementation and policymaking.  Knowing where we are now and where we want to be, here are 10 guiding principles.1. Stop designing health IT by regulationThrough its certification program, ONC directs the specific features, functionality, and design of electronic ...
Source: Life as a Healthcare CIO - March 1, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Third Week of February 2017
As the weather begins to warm, work on the sanctuary gets easier.  Snow and ice are melting.  We ’ve taken the blankets off the horses and left the doors/windows on barns open overnight.  Turkeys and deer are looking for food on the newly visible ground, causing the dogs to bark all day and night.This week, Millie, a 23 year old Welsh pony arrived at the sanctuary.  She immediately bonded with Pippin, our 30 year old Welsh pony.  Amber and Sweetie hang out on one side of the large paddock, Millie and Pippin on the other.  Everyone is getting along well.Millie ’s arrival was a ...
Source: Life as a Healthcare CIO - February 23, 2017 Category: Information Technology Source Type: blogs

Dispatch from HIMSS 2017
As I wrote last week, I expected 2017 HIMSS to be filled with Wearables, Big Data, Social Networking concepts from other industries, Telemedicine, and Artificial Intelligence.I was not disappointed.  42,000 of my closest friends each walked an average of 5 miles per day through the Orlando Convention Center. One journalist told me “It’s overwhelming. You do your best to look professional and wear comfy shoes! ”After 50 meetings, and 12 meals in 3 days, here ’s my impression of the experience1. Wearables, while still relevant have gone from the peak of the hype curve to the trough...
Source: Life as a Healthcare CIO - February 22, 2017 Category: Information Technology Source Type: blogs

Preparing for HIMSS 2017
Next week, 50000 of our closest friends will gather together in Orlando to learn about the latest trends in the healthcare IT industry.What can we expect?I ’ll be giving a few keynote addresses, trying to predict what the Trump administration will bring, identify those technologies that will move from hype to reality, and highlighting which products are only “compiled” in Powerpoint - a powerful development language that is really easy to modify!Here are a few themes1. The Trump administration is likely to reduce regulatory burden but is unlikely to radically change the course of value-based purchasi...
Source: Life as a Healthcare CIO - February 15, 2017 Category: Information Technology Source Type: blogs

Building Unity Sanctuary - Second Week of February 2017
I have been traveling in Japan and New Zealand this week so Kathy had to manage the sanctuary and farm.The major challenge has been the snow, ice, and cold.  While I ’ve been away, 18 inches of snow have fallen, making sanctuary operations more challenging than usual.Pippin, our 30 year old Welsh pony is recovering nicely after his tooth surgery.  He stopped eating and lost weight rapidly because it hurt so much to chew.  The vet sedated him and removed the offending tooth by breaking it into 3 pieces. Antibiotics cleared an underlying gum infection and his appetite returned.  We ’ve en...
Source: Life as a Healthcare CIO - February 9, 2017 Category: Information Technology Source Type: blogs

Dispatch from Japan and New Zealand
This week I ’ve taken vacation time to help my colleagues in Japan and New Zealand with national IT planning.  As I often say, the healthcare IT challenges are the same all over the world, but the cultural context is different.In Japan, I spent 2 days in Tokyo and 1 day in Kyoto, lecturing, meeting, and listening to stakeholders.  There is a great desire to share data for care coordination and clinical trials/clinical research.  Telemedicine/telehealth is increasingly important in an aging Japanese society that has increasing healthcare needs but a limited number of caregivers and few opportunitie...
Source: Life as a Healthcare CIO - February 8, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - First Week of February 2017
Running an animal sanctuary requires constant attention to the care and well being of all the creatures living there.  This week, Pippin, our 30 year old Welsh pony stopped eating hay and required urgent intervention.  He did not appear to be suffering from colic. He ate treats and sweet grain, which we minimize because of his Cushing ’s disease.  We knew he had numerous dental issues but to evaluate the situation he needed to be sedated.  The vet figured out he had a loose tooth that prevented him from chewing grasses.  She removed the tooth, placed him on antibiotic coverage ...
Source: Life as a Healthcare CIO - February 2, 2017 Category: Information Technology Source Type: blogs

We Must Think and Act as One Planet
Over the past few days, several journalists have asked me to comment about travel bans, immigration policy changes, and trends in isolationism.My opinions are my own and do not reflect any official position from my employer or my academic affiliation.Here are my observations1. Information Technology is global.  We hire the best talent regardless of nationality, gender identity, sexual orientation, religion, or race/ethnicity.  Having worked in 75+ countries in my adult life, I can say that innovation crosses all boundaries and cultures.  It ’s just as likely that next big breakthrough will come fr...
Source: Life as a Healthcare CIO - February 1, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Fourth Week of January 2017
The Board of Directors of Unity Farm Sanctuary held its first meeting at the Unity Meeting House the 1830 ’s building on the sanctuary property.  The “board room” is the original dining room, made fromAmerican Chestnut, which no longer grows in New England due to the chestnut blight of the early 1900 ’s.  Since the floor is nearly 200 years old, not a single board is square and a marble rolls spontaneously across the floor.The Board agenda including a walking tour of the entire sanctuary property and a review of all existing survey maps, such as the one below which identifies structur...
Source: Life as a Healthcare CIO - January 26, 2017 Category: Information Technology Source Type: blogs

What is Care Management?
I recently joined the advisory board of Arcadia Healthcare Solutions, a leading provider of analytics, decision support, and workflow enhancement services.  At my first advisory board meeting there was a rich debate about the marketplace for care management and population health tools.  I ’ve spent years studying such solutions at HIMSS and found most of the products are “compiled in Powerpoint”, which is a very agile programming language, since it’s so easy to change…At BIDMC, we think of care management as two things*identifying a cohort of patients based on analysis of financial ...
Source: Life as a Healthcare CIO - January 25, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Third Week of January 2017
This weekend we ’ll run our first Sanctuary board meeting, providing our 7 member board with an overview ofAnimals and activitiesFinancialLegalInfrastructureProjectsOur strategic goals in 2017 areDevelop internship programDevelop educational programsDevelop additional funding possibilitiesDevelop standard intake processDevelop trail plan in collaboration with the Sherborn Rural Land TrustHere ’s a brief update about what we’ll tell themIn February we ’ll take on another horse (Millie, a 20 year old Welsh Pony) and another pig (Penny, the 1 year old Yorkshire).  We ’re making modifica...
Source: Life as a Healthcare CIO - January 19, 2017 Category: Information Technology Source Type: blogs

Building Unity Farm Sanctuary - Fourth Week of January 2017
This weekend we ’ll run our first Sanctuary board meeting, providing our 7 member board with an overview ofAnimals and activitiesFinancialLegalInfrastructureProjectsOur strategic goals in 2017 areDevelop internship programDevelop educational programsDevelop additional funding possibilitiesDevelop standard intake processDevelop trail plan in collaboration with the Sherborn Rural Land TrustHere ’s a brief update about what we’ll tell themIn February we ’ll take on another horse (Millie, a 20 year old Welsh Pony) and another pig (Penny, the 1 year old Yorkshire).  We ’re making modifica...
Source: Life as a Healthcare CIO - January 19, 2017 Category: Information Technology Source Type: blogs