Tim J. Edwards

Healthcare IT, Process Improvement, Making IT Easier

Tim J. Edwards - Healthcare IT, Process Improvement, Making IT Easier

HIMSS09 Tuesday Wrap Up

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Tuesday was my third and final HIMSS09, I had to catch an evening flight back home to be at work tomorrow. Realistically, three full days of crowds, vendors, and education sessions is pushing my limits, but I digress. On to day 3.

Session: Connecting Rural Healthcare Providers to Academic & Tertiary Medical Centers

The session was conducted by Dan Furlong, Project Management Officer for Medical University of South Carolina (MUSC) who was filling-in for their CIO, Dr. Frank C. Clark. “If any of you are hear hoping to meet Dr. Clark, I’m afraid you are going to be disappointed.”

Like everywhere, South Carolina has health problems and they have set out to lead an effort to” improve the health of rural residents by giving them access to the medical expertise found in the academic and tertiary medical centers located in urban areas.” The project will connect 65 rural hospitals and 13 rural clinics and provide access to this medical expertise. The project is funded by a in two ways, from an $8 million FCC grant and matching funding from the project’s governing body, the Health Science of South Carolina comprised of several institutions (MUSC, Spartanberg Regional Medical Center, Palmetto Health, and Greenville Hospital System). As of today, the backbone is in place and the contracts are signed, they are awaiting FCC funding to be released. In the words of Mr. Furlong, “We have found we move a whole lot faster tan the federal government.”

The most interesting aspect of this session was not just the content presented, but the way the audience joined into the conversation. It seems there were representatives from at least 7 other states that were working on their own connectivity projects and Dan invited and encouraged some great collaboration with the folks in the room. The education session turned into a working session and while I was not particularly interested in the details/tacit knowledge being exchanged, it was fascinating to watch.

Session: Who Should Really Be Flying the Project Management Plane?

The session was presented by Dan Furlong and Mark Daniels from MUSC. While Dan’s former presentation was interesting, this session was one I circled right away when I first looked at the HIMSS09 agenda. I believe HIT alignment with clinical operations is the key to success. Dan and Mark seem to be completely in line with this type of thinking.

MUSC has been through the typical IT adoption/integration model; a physician says it would be good if…, the IT department listens then sets out to build it, development and testing happen within IT, the project is completed, and the originating physician says, ” That’s not what I was talking about.” Recognizing the futility of this approach, MUSC set out to change their project management approach. First, they hired a physician CIO and promoted the position to the VP level. From there, they developed a governance process to encourage buy-in, support, and strategic alignment with clinical operations. Next, they developed a Project Management Office and formalized the project management process; focusing on checklists like those used in the airline industry.

The result of this work is seamless alignment between IT and clinical operations. In fact, physicians are so heavily engaged in leading projects that MUSC experienced issues over the title “project manager.” In the end, they had to provide education to separate the role of physician leadership from the process management conducted by project managers. Like all implementations, there were bumps, but the model is working well for MUSC today.

The best part of this session was the “quote feast” generated by the presenters

  • Developers always embellish
  • Failure does not require scapegoats
  • Seats without commitment are best left empty
  • Projects have no coach seats

Session: Driving IT Innovation and Quality Across the Enterprise

This session discussed the challenges of connecting disparate systems found as UPMC and was a nice overview of the process they used for integration. Like everyone else, data quality is an issue for utilization of data in the system.

Seems to me that the data quality theme will be one of the major topics for HIMSS10. How will we address data quality? Does limiting those with input access to data solve the problem or is it oversight and integrity checking. Perhaps both approaches are needed. Automation can be an answer, but not everything can be automated and are still facing the daunting challenge of getting what is in the clinician’s head into the medical record for all to share.

With that, I’m off to the bag check and on to O’Hare. Later tonight or tomorrow, I’ll post a overview of my experience at HIMSS09 including pictures and some video (I think). Thanks for reading and tweeting along.

  • Daragh O Brien says:

    Tim,

    Interesting post. Information Quality/Data Quality is a challenging area. Only today, the UK Audit Commission slated the NHS Data Quality programme ( http://bit.ly/KL9q) for lack of rigour.

    Controlling access to data and rights to create/update/delete data is one way to help ensure quality. Buying in tools to help implement governance, oversight and checking is also an option. However, if you think of your database as a lake, this amounts to not much more than blocking input from certain streams you know to be dirty and having filtering and cleaning processes to clean the lake water (even if pollution is still coming in from elsewhere).

    However, the key lessons from other industries (and from manufacturing quality) is that the optimum solution is to move your quality metrics and controls as close to the point of information creation as possible. As part of that you need to understand the process, ensure your people are trained in the process, and ensure that your people understand the WHY of the process as well as the HOW.

    By understanding your process, and how that links to the objectives of your organization, you can better identify what metrics matter and make better decisions about tool investments and targeted actions to tackle root causes in process, technology or people issues.

    The IAIDQ held a webinar back in March on the topic of Data Quality in Healthcare. Problems on the audio recording meant we couldn’t put up a podcast, but the slides can be found here: http://bit.ly/COG2L, with detailed speaker notes here:http://bit.ly/viYO

    [Disclosure: I'm the Publicity Director of the IAIDQ, the only professional association focused solely on the challenges of Information/Data Quality.]

    April 9, 2009 at 4:00 am

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