Author Archives: hospitalcio

Is Epic MyChart Struggling with Vista?

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Even though my hospitals run MEDITECH or GE Centricity, I have an Epic MyChart account.  I really wanted to see how well Epic worked in the clinic and I wanted to be able to see their MyChart patient portal.  So, I scheduled an appointment with a competing health system to check things out.  It was actually very interesting experience and worth the time (despite a thorough physical exam).

I was most impressed with MyChart.  It far exceeds what anyone esle has, including niche vendors in this area.  With the exception of e-visits, it is a fairly comprehensive system.  Perhaps the most impressive is the ability to do true round-trip scheduling.  This isn’t the ridiculous “request an appointment” blank forms that take more time and effort than driving to the clinic.

Frankly, MEDITECH has fallen so far behind in this area it is disappointing.  While they have a product, I am unaware of anyone that has implemented it.  Maybe they have something up their sleeve.  But as of now, they are way I believe that are way behind Epic in this area.

While MyChart is way cool, they seem to be having trouble with Vista.  At least the provider I went to is having a problem.  I suppose it could be something unique to their implementation, but that seems unlikely.  Here is an excerpt from an email that I received from that provider:

If you have Windows Vista, please do the following to maximize the performance of <snipped provider name> on your computer:

Within Internet Explorer, open Advanced Internet Options from the Tools menu Scroll down to the Security Section and disable TLS 1.0

Yikes.  I think your average patient would struggle with these directions.  I wonder if there are any applications that would break as a result of disabling Transport Layer Security.  I am unaware of any.

Computer Security Education Without the Caffeine

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I am a big fan of podcasts, I listen to them as I drive across Wisconsin.  Mostly, I listen to podcasts related to my hobbies (Daily Giz Wiz, Grammar Girl, and Endurance Planet).  But there are a few podcasts that are educational.  One of them is Security Now, a podcast discussing various aspects of computer security.

Now, the only thing I find more boring than computer security seminars is compliance training.  But it really does not have to be that way.  It is fascinating and scary to understand how people are exploiting the Internet, networks and the desktop for nefarious purposes.  Security Now keeps me interested and helps me ask good questions about our preparations to prevent various threats.  Check it out.

Google Maps Snaps My House

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Only a nerd like me would be excited about this.  Streetview is an awesome feature of Google Maps.  It allows you to see 360 pictures of the streets in Google maps.  Google has mostly taken pictures of the streets in big cities.

Yesterday, Just as I was arriving home from work there was a car with a fancy camera mounted on a pole that extended high above the roof.  On the side of the car was a  magnetic Google sign.  I recognized it as the car that takes the Streeview pictures.  I hope it caught me in my car.  I was amazed that Google was already photographing the streets of this relatively small town.

I wonder how long it will take for the pictures to appear.  I will check periodically.  If there are pictures of my car or houe I will post the link.

PACS: workflow is the often missed key

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When we selected our PACS system we over-emphasized our desire to archive images (“going filmless”).  We failed to really understand the entire radiology workflow.  The paper requisition is such a key today to drive workflow and document information needed by the reading radiologist.  Consequently, films are available for reading, but still sit in the queue waiting for the paper requisition and the hand-written notes.  Furthermore, the techs are still moving that piece of paper all around the department.
We had developed scenarios, but somehow we missed all of these key workflow steps in the process (ouch).  Our PACS system is great at capturing, storing and moving around images.  But we missed out on a host of workflow improvement opportunities.   So, we are busy developing workarounds using other systems and scanning solutions.

Goals

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Reaching a goal should be your reward for all of your hard work. Set challenging, but achievable goals. On a daily basis allow yourself to visualize the moment that you reach your goal. When it happens, embrace it. It is bound to be different than you had planned. When you reach your goals, have a smile on your face that tells everyone that you are completely satisfied.

2007 Chicago Marathon Finish

How much time do IT folks work on projects?

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I spend a lot of time analyzing how much time we spend moving forward strategic initiatives, versus support and minor enhancement work.  As I have looked at our various operations over time I have found that number fluctuates between 15% and 25%.  So, if you have 10 analysts in an IT department, your only getting 1.5 to 2.5 FTEs of project work.  Hardly enough to accomplish a big project.

We spend a lot of time talking about how we can get that number higher. And like anything you want to improve we have to measure it.  Our IT team track all of their hours so we can analyze the data.

This year we are estimating that we have the capacity to work on 100,000 hours of IT projects.  But, the nature of that work is that there is a lot of inefficiencies.  Folks are not on an assembly line waiting for the next part to arrive.  There are a lot of stops and starts.  It will be interesting to see how much project work we actually complete.  I would not be surprised if it is less than 50,000 hours.  I will let you know.

How much does email cost?

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Our manager of data center technologies, Chris Fallin, has done a great job of designing an upgrade to our Exchange-based email platform. The design is enterprise-class (highly redundant and highly recoverable). But it also manages cost by reducing some of the unnecessary redundancy we have today. We will be implementing tools to manage email retention and e-discovery. We will also are buying tools to monitor the platform and manage the migration from Exchange 5.5 to 2007.

In total it will cost us $1.5M to upgrade our email platform. This includes a mix of Servers, OS, System software, Network upgrades and Microsoft Client Access Licenses.

Additionally, our cost to maintain that system (software and hardware maintenance and network connections) will run about $760K over the next 4 years. At that point we will need to upgrade hardware again (at least).

Given that we have 15,000 email users, I calculate our cost of email, for the next 4 years, will be $3.14 per user per month.

The No Bid List

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Managing vendor performance is a key part of my job.  When a vendor does not meet expectations they are placed on “The List.”  I tend to have a long memory and it can be hard to work your way off the list.  Especially since it means we don’t allow those vendors to bid on work.  I need to validate my worth to my organization every day.  I have the same expectations of our vendors.

Healthcare IT Lawyers

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I see my old friend Rob Petershack has started a blog at:

straighttalk-aboutitandip.blogspot.com

Rob is a healthcare IT attorney that I have always enjoyed working with.

In general I don’t use outside legal assistance when I am negotiating a contract. But I do think it makes sense when you are negotiating a large deal. Using an attorney with healthcare IT experience is great.

The trickiest part of negotiations is taking a mutually agreeable concept, like system availability, and developing mutually agreeable language. A really good attorney will bring a bag of scrubbed clauses that really help you get from idea to written agreement.

Rob has always done a good job of organizing the discussion and proposing workable language. He also used to be internal counsel for one of the larger HIS vendors, which can only help. Rob is at Axley Brynelson now (based in Madison). You can track him down at www.axley.com.

There are a lot of parallels between the IT and Legal departments. In both cases business leaders are often willing, even expecting, IT to take make business decisions on their behalf to finalize a broad concept. We both struggle with keeping our customers engaged once the initial glamour of the new effort is gone.

Microsoft Loyalty

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As I was cleaning out my inbox spam I came across this press announcement:

“I am very pleased to announce that SWC has received the Microsoft Central Region Partner of the Year Award for Loyalty.  In receiving this award SWC has been recognized from a community of over 12,000 solution providers in 18 states. This is a great honor for our organization and one that marks a tremendous period of success and accomplishment.”

I am not sure what SWC does.  But, this press release makes me less likely to find that out.  I want a technology partner that is loyal to me, not Microsoft.