Candid CIO

I think the folks at the Affinity marketing department have passed me up in terms of web savviness. Earlier this decade I felt that they did not “get it” when it comes to the web. I had tried to retain control over the creative portion of the web site. Then, I would go to marketing and make sure I got the logo and colors right.

But, with the demands of clinical IT I have not been able to make the web a priority. It turns out our web site did not need me. The Affinity marketing folks are putting my efforts to shame.

The most popular page on our web site (and nearly all healthcare provider web sites) is the jobs page. If you don’t have an online job application you are WAY behind the times. Time to jump on the clue train.

The second most popular area are those related to the find-a-physician function and the associated physician profiles. At Affinity we are using a technology called “Webouts” that make physician profiles pop off the page. Check it out:

http://www.affinityhealth.org/page/physicianProfile.html?id=1882

I wish I had thought of that. But, I am more delighted that more and more people are seeing the web as an important aspect of nearly every organizational strategy and we are benefiting from the collective wisdom of the folks looking to leverage the web. Plus, it is really cool.

FCG was one of the first “boutique” consulting firms in the healthcare IT (HIT) space. It was founded by the late Jim Reep and Zan Calhoun. Now, it is part of HIT history.

I believe I was at FCG during the golden age. There was not a lot of structure, but there were a lot of talented people figuring out this new industry. We were staying a few steps ahead of our clients. I remember working on a strategy project and we were arguing about the necessity for a PC network as part of the strategy. That’s how young the industry was.

Back in those days (1987 - 1990) Jim and Zan would shut down the entire company for one week and take us on a retreat in San Diego’s Pala Mesa resort. Somewhere I have have a picture of the staff at my first retreat - the first 50 FCG employees.

This was in important time in my life. I gained a lot of self-confidence and learned what it meant to love your work. I also had a lot of great mentors: Zan, Karen Reed, Julie Bonello and Steve Heck. I also loved my peers in the Chicago office: Pete and Andy Smith, Liz Krimendahl, John Hoben and many others. I still cherish my memories of Friday afternoons at Wrigley Field with this cast of characters. Work is great when you have a sense of camaraderie with your co-workers (which is why I am so happy now).

We were a small firm then. I remember our first $1M month. When FCG was sold to CSC they were a much different public company earning many times that. Good times, then. Good times, now.

I love some of the web 2.0 tools.  I use a lot in my personal life and some have even crept into the enterprise…

QuickBase

I have blogged in the past about QuickBase.  This web-based tool allows the average person to create a simple database application.  It has taken off like wildfire in our organizations.  You know something is meeting an untapped need when you see this kind of organic growth.  The other validation is the acceptance by our partners.  Consultants, vendors and others take to QuickBase quickly.  Because it is web based you can add an external person without going through IT.

We have over 3,000 applications in QuickBase.  The vast majority are created by non-IT users.  There are some common applications like team workspaces and contract issue tracking.  Some are more unique like the one we created to track schedule our interpreters and track their time.  I am aware of scores of niche applications that we have been able to eliminate or avoid because we were able to meet the need with a QuickBase application.  It is a great value and QuickBase has proven to be enterprise-class in its stability.

Gliffy

Gliffy is a web-based drawing program ala Visio.  It is much simpler than Visio and the missing functionality appears to be the kind of stuff that the average user does not miss.  I have been using Gliffy quite a bit lately and an considering using it as a less expensive Visio alternative.

Twitter

My use of twitter seems to inconsistent.  at time I track my ever move.  Then I get out of the habit of updating it for a few days.  Because I record how I spend my time it helps me keep a history of what I do.  More importantly, it is a great way for my folks to keep tabs on my.  My 160 team members are spread across Wisconsin.  This is there way to see if I am reachable and how to best reach me.

Does anyone out there have other web 2.0 favorites?

I have never striven for 0% turnover in the departments I manage. I think it is great for new people to enter our organization and bring new ideas and renewed energy. I also think it is good for people to be exposed to different careers, especially when they are young. So, when someone announces their departure I usually accept the news in good spirit. This time was different.

Sue announced that she will be retiring from Affinity Health System in June. She was employee number 2 in the Information Technology department (back then it was data processing). This was several years before we had our first computer. Instead, Sue was responsible for organizing key punch jobs that were sent to a mainframe computer that was shared by several hospitals.

Sue has always kept meticulous records. I always found it ironic that someone with this much IT experience loved her paper records. I suspect she has seen a lot of computer disasters. As proof of this behavior, I submit to you this:

This is the letterhead from Sue’s offer letter which is still in her files. Did you notice the date? I would encourage you to click on the image so you can see the entire offer letter. It includes an attempt to phototcopy a picture of the equipment (graphical printing did not exist). There are some precious historical references here, including:

• Sue’s starting salary was $2.25 per hour (she makes more now)
• Sue’s supervisor felt compelled to explain the function of a CRT
• The Data Processing department consisted of the following state-of-the art hardware:
  • Control Data Corporation (CDC) 200 User Terminal
  • (2) IBM 1050 Data Terminals
  • (2) 029 Key punch machines

Sue, thanks for your years of service. Your willingness to keep learning has allowed you to adapt to multiple generations of technology. More importantly, you have touched many lives, including a lot of patients you never got to meet. Enjoy your much deserved retirement.

The problem with not using consultants is that when you do want one, they are hard to find.  I had been keeping in touch with Andy Smith since I left FCG 18 years ago.  So, I sent him an email today asking if he could help me with something and his email bounces back from the FCG server.  Sheesh.

So, I am trying to do some good old fashion benchmarking of similar-sized IT organizations.  I know that HIMSS Analytics has some data.  But, I really need a consultant to help me with data gathering on my side and turning that data into some insightful analysis.  My plan is to present this to my IT Customer Advidory Board (aka Steering Committee) in the first week of February.  They have been asking how we compare to similar organizations, which is a good question.

If anyone has an idea who might be good at this please leave a comment here on the blog (so everyone will know).  This is a rare opportunity for a healthcare IT consultant to make a connection with our organization.

One of the best moves I have ever made was selecting and installing the Purkinje ePrescribing product. Purkinje sells an EHR product too, but I really cannot speak to that.

Purkinje uses the Software as Service model, so there is no server hardware to manage. You just need to set-up a secure connection to their data center over the Internet. The software is web-based, so we did not have a special client to install.

We have been using their ePrescribing tool for nearly 5 years and our physicians really have embraced it. It is very simple and our incidence of downtime and unavailability have been well within our expectation. Purkinje had some great functionality that the bigger players did not have when we made the purchase. Most importantly, the system has a lot of clinical content that reminds our doctors about clinical research and costs specific to the illness they are treating. So, for example, if a doctor is treating a hypertensive patient for the first time the system will provide the doctor a quick, unobtrusive alert that reminds them diuretics are the preferred first line of therapy in most patients and a fraction of the cost of most alternatives.

We were able to get rid of the prescription pads quickly.  I have heard many anecdotes about the system catching medication and allergy conflicts that might have otherwise been missed.

Through interfaces to our MEDITECH Magic HIS the doctor’s are able to select patients from their schedule that appears in the ePrescribing system. Each time the medication list is updated we send a report in MEDITECH so our patient’s medication list is available in MEDITECH’s PCI.

This is why I support Medicare’s push for electronic prescribing. Unlike the Leapfrog group’s poorly considered call for CPOE, ePrescribing is easily accomplished, commercially available and proven to truly be be beneficial to the health, safety and pocketbook of patients.

When will they learn to stop sending me these inappropriate offers of free travel and resort hotel stays?  Here is the latest one to come into my mailbox.  The rooms at this hotel start at $500 per night.  I am used to the Stevens Point Fairfield Inn where I get a $59 per night rate.  I can’t believe anyone would find this ethical:

Hello Will, I’m pleased to invite you to a 1-½ day event that will be well worth your time: a leadership retreat with [vendor] executives and a small group of your peers from other companies. [vendor] will sponsor your stay at the St. Regis Hotel in Monarch Beach, California covering one night room accommodation and air travel if needed.Our goal is to help you identify areas where you can develop technology pathways that satisfy your unique organizational goals.You can expect the following benefits from this event:

{ Good morning 2008 *~Originally uploaded by » GUM «

My New Year’s resolutions:

• Run more
• Post more

So far, post more is ahead of run more.

Books I am reading:

• Why Most PowerPoint Presentations Suck (thanks John Brasfield)
• Again to Carthage (thanks Lynne Griffin)

The whole concept of Search Engine Optimization (SEO) is wasted energy. I can’t believe that there are books, conferences and gigabytes of web pages dedicated to the idea of gaming the google page ranking system. All of that energy should be spent on creating compelling content that people want to read.

I got my wife and daughter a MacBook for Christmas. They want to create some videos. So, I also got them a Flip video camera that stores all of the video in solid state memory. This was going to be the ultimate in easy movie creation. Except, the iMovie 08 does not import the .avi files that the Flip camera creates. The previous version of iMovie did this, butI guess the Apple folks decided this would be a good thing to remove in the latest version. So, now I have to teach them how to convert the video. What was going to be simple is now complex. Why is my home life so much like my work life?

I upgraded my PC running Windows Vista with a new hard drive. My plan was to store all of the data files on one drive and to keep the OS and applications on the existing drive. This was easy in XP, you simply right clicked on the Documents folder and changed the target location. But the data folder structure has changed in Vista. The top data folder is called Users. There is no easy way to move Users and all of the sub-folders to a new location. I have seen some ways to do it through registry changes, but it was too complex, time-consuming, and risky. My new drive is sitting empty in hopes that Microsoft will address this. I guess this is just another reason to avoid Vista.

One more home electronics rant…when will gadget makers realize that tiny raised icons on black background is not the way to sell to those of us over 40 that can afford to buy them?

Congtats to Picis for sending me my first 2008 HIMSS networking (party) invite:

Meet healthcare IT professionals who aren’t

Join Picis at a grooving cocktail reception at the
House of Blues Voodoo Lounge.

Monday, Feb. 25, 2008, 6-8 PM

Cocktails
Hors d’oeuvres
Music
Entertainment 

1490 E. Buena Vista Drive, Lake Buena, Fla.

If you eat enough of those hors d’oeurves you can make it a meal.  You might want to consider bringing you own large Chinet plate with you to circumvent the provided small plates.

As for me, I am on the fence about attending HIMSS.  I have sat out the last couple of years and have not missed it.

When discussing large projects (like an EHR, ERP, or replacing an HMO claims processing system) I often use the phrase “all hands on deck.”  I am trying to convey that these projects not only expend IT resources, but those business leaders that need to re-develop all of their core business processes around the new technology.  Additionally, there is a ripple effect that impacts senior leadership and even those in departments that you would not expect to be effected.

But, I am starting to think that isn’t an effective way to communicate the resource-intensive nature of these projects. Often I am asked what I mean by “all hands on deck.” Secretly, I fantasize about re-enacting this scene from The Professional:

Of course your business cannot come to a halt for a single project.  You still need to advance other strategies and respond to competitive threats.  You need to make sure you are still providing a quality service to your customers.  But, I believe most organizations err to underestimating the effort.   Large IT projects will impact what you can hope to acheive in other areas and if leadership’s ambitions are not scaled appropriately you will end up with overly-stressed staff and a project that doesn’t seem like it can ever get the attention it needs to finish.  So, it maybe beneficial to be a little melodramatic when explaining the resource need.