Monthly Archives: August 2009

Building a Healthcare IT Team

I am a management consultant with experience in a number of industries including HIPAA in healthcare. Electronic medical records (EMR) appears to be an area where I can make a contribution and a living. But, the opportunity is more apparent than real.

Several things I have noticed:

  • Widespread concern in the press about the availability of the people who will be needed to implement near-universal EMR.
  • Almost all of the open positions I have seen have a strong requirement for hospital or other healthcare provider IT experience.
  • Almost all of the positions are for programmers and other “technical” staff; almost no analysts or others skilled in exploring what is really needed and how current technology and advances on the horizon can be put to good use.
  • There is no clear definition within the industry of the scope for electronic medical records.

Of course an IT team should include a lot of direct experience in the specific industry. But strong teams are made up of people with diverse and complementary skills and experience. Effective healthcare IT requires a wide range of skills and experience. The quickest way to develop that range is to incorporate experienced people from other industries who have relevant IT experience. As part of a team they will learn the fundamentals and most of the nuances of healthcare quickly. With fresh eyes, they will make unexpected contributions. They will stimulate the discussions about options and solutions. And, they will bring new points of view about IT and the world with which healthcare must interface, e.g., patients who are growing more computer savvy, healthcare related products and services beyond the normal bounds of healthcare such as retail drugstore clinics, online medical advice, and evolving electronic medical devices.

A friend of mine writes business cases for companies seeking early stage investment. A recent client was a group of doctors who wanted to develop and market a computer application related to their specialty for use in hospitals. They asked hospital IT managers they knew for recommendations for system development support. The recommended “experts” in hospital systems development agreed to take the assignment and offered to assess the competition. For openers, they said there was no significant competition. My friend quickly found there was a significant competitor. Failure to know and disclose that to investors could have led to a lawsuit. Well into the development project, my friend asked me to review what was being developed. Even with my limited healthcare background, it was obvious that the requirements analysis process had missed several key elements. They had started coding before they thoroughly understood how the system should deliver value. In addition, substantial parts of what they were building and charging for are readily available in the market and could have been licensed at a small fraction of the cost of development and would have been available much quicker. The “experts” do know hospital procedures and are good coders but they simply do not have the breadth of experience to identify specialized system requirements, assess the competitive market, or the state of the art of assembling existing elements to support the truly innovative parts of a new application.

If you want a stronger species or IT team, deepen and expand the gene pool.

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Inspired by a Twit from HealthcareITJob || How To Build Your Team Now So You Can Play (Not Pay) Later Posted on: 8.20.2009 6:53:57 PM http://tinyurl.com/mzmyxk

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Including patients in EMRs

I recently responded to a question on Linkedin related to electronic medical records: Health 2.0 Group http://cli.gs/tmBWjr In the response I included: “… unless patients are included either directly or via interconnects such as Microsoft’s Health Vault or Health Google, the value of the records are very limited.”

The next response by a Linkedin members was: “This is a very naive statement. A very close statement would be to make the same claim about bank records, which for the most part, the value in interconnecting them does nothing for the financial benefit if the account holder…”

I would argue that including customers in bank records provides significant value:

  1. I can go online or to an ATM and get my balance and my statement at my convenience because I am now able to connect to my bank records
  2. I can go online and mange my credit cards which are issued by banks even if they have an airline or gas station logo on them
  3. I am able to use home banking to receive and pay bills which can be very convenient.
  4. I am able to use home banking for financial record keeping including historic records for several years
  5. I am able to move money between my bank and brokerage accounts relatively quickly at no cost
  6. My bank records are linked to credit rating agencies and I can link to that information which facilitates finding and resolving errors that affect my ability to get a loan; the problem of errors was big enough that congress acted to provide this added protection and I suspect we will find the same issues with electronic medical records.

Some analogies between bank and medical records would include:

  1. When did I or a family member last have a checkup for X? When should I schedule my next one?
  2. My EMR should provide medical record keeping similar to the financial record keeping with my bank
  3. I will be able to use CVS clinic type facilities for minor medical issues for convenience and cost reduction and assure that that visit and the treatment are known to my regular physician so she is fully informed
  4. I will be able to review my medical records and take appropriate action – yet to be determined – to at least comment on errors and perhaps get them corrected. Potentially good for my health and my insurability.

Some other benefits of including patients were discussed in my last post: What if? What if we expand the definition of EMR?