02 Jun
Posted by Ted Eytan as del.icio.us bookmarks
Tags: ccr, google, standards
Popularity: 20%
02 Jun
Posted by Ted Eytan as del.icio.us bookmarks
Tags: ccr, google, vendors
Popularity: 17%
26 May
Posted by Ted Eytan as del.icio.us bookmarks
Tags: google, health2.0, pharmaceuticals, unbranded_doctor
Popularity: 31%
24 May
Posted by Ted Eytan as del.icio.us bookmarks
Tags: ccr, google, standards
Popularity: 19%
23 May
Posted by Ted Eytan as Connectivity for Californians
Tags: a3, California, California Healthcare Founcation, Employers, google, hypertension, LEAN, Microsoft
Popularity: 44%
A3 (Project Plan). Click here to learn more about what an A3 is
This post contains the A3 Document, or the Project Plan, for Connectivity for California Consumers. I have been posting some of the data that supports this plan on this blog (click here to see them all). In addition, I have been working with staff at California Healthcare Foundation and potential stakeholders to improve the plan.
For those of you unfamiliar with the A3 format, it is designed to (a) tell a story and (b) incrementally improved to the point that the actions are clear at the time a project is launched. It may be revised once a day or even more often. The process of discussing the project and making improvements is called “nemawashi.” I am using this blog for extended nemawashi, so please post your comments.
Since an A3 tells a story, starting on the left, going down, and then on the right, I will summarize the story here. Feel free to print out the A3 and follow along (A3 means “11 x 17″ paper. You may have to shrink to fit on letter size).
Issue & Focus
Current Condition
Problem Analysis
Target Condition
This pilot seeks to create a functioning ecosystem that supports chronic disease management across the lifecycle, with the best candidate being hypertension
Action Plan
We began by interviewing example employers, health care providers, and technology providers to understand which approaches and components appeared most promising. At this time, it seems most reasonable to approach this first from the employer perspective.
Next step will be to convene a group of potential partners in June or July, 2008, at California Healthcare Foundation, to discuss how pieces would fit together.
A presentation would be made to the CHCF Board in the fall, with funding and activity to begin in 2009.
Cost / Cost-Benefit / Waste Recognition
There are recognized wastes, which include unnecessary visits for blood pressure monitoring, inadequate medication therapy, and inadequate use of the health system, for patients who have not been seen in the past 12 months.
There are costs including, technology costs (although the goal is not to build anything new), and realignment of incentives to support non-visit-based care.
Followup / Unresolved Issues
Points of concern and planned countermeasures
So that’s the script that goes with the story, more or less. Comment away, and keep in mind that each comment will change the A3 a little every time.
22 May
Posted by Ted Eytan as Opinion
Tags: ccr, google, phr, standards
Popularity: 31%
Colleague in patient empowerment Susannah Fox e-mailed me this question and so we thought we’d start one.
Jay Parkinson, MD, linked to a discussion happening on Digg in his blog. E-patients is also hosting an informed discussion on their blog.
Is it cliche to say that this is evolutionary, not revolutionary? I think it’s of benefit to patients and our profession that a dialogue has started around moving health care data in a standardized way to a place where people can aggregate and do things with it to improve their health. A year or two ago, it was hard to think about a standardized extract of a medical record that you could send from an EHR system except in very specialized situations. Now you can do with several partners, Google being the most recently announced option.
I didn’t even think about writing a special post about it, even though I thought, “Cool, this work will support the ideas I am exploring with the California Healthcare Foundation, that patients can be involved and active in their care, across health environments (health system, work, play).” So rather than writing about it, I just incorporated the possibility into the work we’re already doing, which is great.
I think of privacy as a state of being that allows a person to feel comfortable seeking health care regardless of the issue. This is a good place to be, and when that state of being doesn’t exist, people will seek it out, even if it means not seeking needed care, which could be devastating both to patient and health system. At the same time they seek comfort, they also want to build confidence in their ability to manage their health by having as much information their care as possible. In systems where patients have good access and trust, the care is better, and it feels great (and is great) to provide and receive care in that setting. Both things are important, we should not sacrifice one for the other; every patient deserves to achieve their life goals through optimal health.
22 May
Posted by Ted Eytan as del.icio.us bookmarks
Tags: AAFP, ccr, chcfp, cmio, conflict_of_interest, DC, EMC, google, healthcare_renewal, hypertension, Informatics, Leadership, npr, PDF_healthcare, pharmaceuticals, phr, physicians, standards, transparency
Popularity: 63%
May 15th through May 18th:
03 Apr
Posted by Ted Eytan as del.icio.us bookmarks
Tags: AAFP, acp, conference, Conferences, deloitte, disruption, google, health2.0, medical_home, my own cio, paper, patient_centered_care, reimbursement, store_and_forward, Twitter, video, voice, voicethread, Web2.0, wordpress, zotero
Popularity: 94%
April 1st through April 2nd:
22 Mar
Posted by Ted Eytan as del.icio.us bookmarks
Tags: employment, enterprise2.0, GenX, GenY, google, leadership_blogs, LEAN, primary_care, reimbursement, Web2.0
Popularity: 66%
March 18th through March 19th:
18 Mar
Posted by Ted Eytan as Now Reading
Tags: Baby Boomers, enterprise2.0, GenX, GenY, google, IT, Web2.0
Popularity: 51%
This book was recommended to me by another Health Information Technology professional, and I really got a lot out of … the first half of it. I was so on the fence about what I thought about it as a whole that I looked up both the review of the book on BusinessWeek.com, and I read Nicholas Carr’s article “IT Doesn’t Matter,” from the Harvard Business Review to check on my thinking.
I’ll start with the first half, which was very engaging and engrossing, comparing the rise of the electrical industry to the commoditization of information technology. I have read about the electrical industry before, but not so well laid out. There are many parallels worthy of drawing, such as the way our culture was deliberately and unintentionally changed as a result of electrification. Fascinating, especially around the way that managing a household changed - the same number of hours doing house work, just higher expectations and more technical skill required. This is where the HBR article also helped a little bit, because the concepts are important for health information technology. In the article, he says
In the earliest phases of its buildout, however, an infrastructural technology can take the form of a proprietary technology. As long as access to the technology is restricted - through physical limitations, intellectual property rights, high costs, or a lack of standards - a company can use it to gain advantages over rivals.
That sort of sums up the state of Health Information Technology, and a nice analysis done of this recently also alluded to the idea that there’s an inertia present among vendors that’s keeping HIT in this phase.
That’s unfortunate.
That HIT though. What about the rest of IT within a health care company - the storage servers, the document creators, e-mail, etc. He says
In the long run, the IT department is unlikely to survive, at least not in its familiar form. It will have little left to do once the bulk of business computing shifts out of private data centers and into “the cloud.”
The HBR article helps here as well, where he says that the IT buildout in most companies is complete, and “Commodities can be essential to business without being essential to strategy.”
The second half of the book is about the “World Wide Computer” and the implications that it has for privacy and the general threatening of industries as we know them today. I think the data about the publishing industry is compelling and of note - 13 percent, or 150,000 jobs lost since 2001. This potentially awaits any industry that is disintermediated.
I thought, though, that this section was written for a different generation of reader, though, one who has not grown up with computers. It’s a nice overview and a lot of the truths make sense, but they didn’t seem like revelations to me in my GenX state. I was really hoping for more detail on how the new IT department would be like and how companies were moving to things like employee asset management and software as a service.
So, maybe worthy of a read, at least the first half, from your local library or book rental service (more on this in a future post).
There are some provocative ideas and I would be interested in learning about companies that are moving to software as services across the enterprise, so reduce the waste of excess storage and maintenance of data centers. If anyone knows of companies doing this, let me know either in the comments or by contacting me directly.
| S | M | T | W | T | F | S |
|---|---|---|---|---|---|---|
| « May | Jul » | |||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| 15 | 16 | 17 | 18 | 19 | 20 | 21 |
| 22 | 23 | 24 | 25 | 26 | 27 | 28 |
| 29 | 30 | |||||