Monthly Archives: January 2012
One thing you are sure to find this time of year are predictions. I’ve decided to do my own not so much to join the crowd but rather because I look forward to comparing my predictions to what actually happens in a little less than a year from now. So with that, here are my predictions for the year in HIT – which ones do you think will come to pass, and which ones have I missed?
1. mHealth experiences a re-birth
mHealth is all the rage and for good reason – it holds great promise to make a significant impact for both providers and consumers alike. But while mHealth for consumers is still on the upswing of innovation and expectations, mHealth for providers is starting to pass the Peak of Inflated Expectations. Walk the floors of any HIT trade show over the last year+ and you were bound to run into iPads at every turn – not necessarily because these vendors were mobile app developers, but because they either 1) wanted you to think they were or 2) managed to make their products “accessible” via a mobile device. But accessible is not the same as usable or efficient. Perhaps the most public example of this was chronicled in a CIO magazine article that described physicians handing in their iPads after a poor experience accessing their EMR. This doesn’t signify a failure of mHealth for providers, rather it was a failure to recognize that app design is arguably more important on a mobile device than in a portal/web or desktop application. Design flaws and workflow gaps are even more exposed on a mobile device. Now that the market has begun to recognize and experience this reality, intelligently-designed mobile apps (whether native or web apps) will continue to rise to the top and carry providers through to the Slope of Enlightenment.
2. Providers begin to expect full workflow support on mobile devices
This prediction is admittedly a bit late as providers have already moved beyond mobile access to clinical results to expect full workflow support. And why not? We should not expect a physician to access lab results on his/her iPhone only to set that device down on the nursing station next to the computer terminal (that is already in use) to enter orders, document care, enter a charge, etc. Perhaps what has fueled this expectation the most is the iPad and other tablets (though not many others). Not many would expect to enter a clinical note or use order sets on a smartphone, however, the tablet form factor presents a new opportunity to do just that – support a physician’s entire workflow. Full, integrated workflow support is a (perhaps the?) critical component of sustained physician adoption of HIT. Where reasonably-sized form factors are concerned, this will also hold for mobile workflows.
3. What worked for Stage 1 will not for Stage 2
My summary of the first year of Stage 1 Meaningful Use (MU): fewer than expected (or budgeted by OMB) meaningful users in year 1, lots of confusion and less movement due to the Stage 2 delay that wasn’t a delay, and early movers characterized by the use of existing systems to meet the bare minimum Stage 1 objectives (e.g., using ED systems to achieve the 30% CPOE threshold). But many hospital IT and physician leaders have already or will soon realize that a Stage 1 strategy isn’t likely to succeed for Stage 2 and beyond. The latter stages are going to require much deeper adoption, use and exchange of health information. IT leaders will need to lay a strategic path that considers all stages of MU, ICD-10 migration, efficient revenue capture, ACO/Value-Based Purchasing and a litany of federal, state and local priorities if they are to be successful. Each of these and other priorities hinge on efficient, meaningful use (pun intended) of integrated systems that respect and protect physician efficiency (and revenue) if they are to succeed.
4. ICD-10 is not Y2K
As the fireworks exploded in Times Square last night, someone said to me “remember how freaked out everyone was at this very minute back in January 2000?” Yes, I do, and the fallout (or lack thereof) threatens to put providers and hospitals significantly behind the ICD-10 eight-ball if they consider that migration to be another non-event like Y2K. Most reports, surveys and commentary place providers and hospitals significantly behind in their preparations for migration to ICD-10. This will have to change in the coming year. But I believe the challenge and emphasis will ultimately be on documentation and not on systems simply supporting the 4-fold increase in the number and format of ICD-10 codes. IT solutions that focus on improving documentation (thoroughness and efficiency) will best prepare providers for ICD-10 and shield them from the potential loss of revenue.
5. ACOs will (continue) to get more attention than they deserve
This is not a repudiation of ACOs or what they attempt to accomplish. But ACOs have dominated much of the conversation during the latter half of 2011, and I expect that to continue. While the tenets and concepts of ACOs are likely here to stay, I still think it’s too early in that process to warrant the airtime to-date. Instead, providers will continue to focus on many of the critical building blocks required to support successful ACOs in the coming year – they just won’t necessarily be doing so in the name of a formal ACO. Do you sense a common theme? Use of integrated, efficient systems in the name of care coordination and higher-value care. While ACO will undoubtedly continue as the preferred acronym of the day, the foundational work required to support an eventual ACO model will be where the real action happens.
Happy New Year!
‘Twas the night before our 14thChristmas and the kids are all snug and dreaming
While I sit reviewing tasks with Pandora in the background streaming,
With SecureGirl reading her iPad and Major tucked in by our side
I better get to sleep soon if I’ve hope of waking up to ride,
Their homework done and jackets hanging upon each door hook
The kids had just finished reading yet another Harry Potter book,
Then suddenly I jumped remembering what I’d neglected to do
I’d forgotten to leave Santa his cookies and cold brew,
If there’s one thing over the Christmas Eve years I’ve learned
The Jolly Old Elf’s pint on this night is indeed hard-earned,
So I slipped out of bed and descended to the kitchen fridge
Only to see his silhouette perched high upon the frosted ridge,
“Whoa team!” he shouted, “Take a break you overzealous reindeer!
Finally I’m back at the Umbach’s; I can’t wait to grab that annual beer!”
Eschewing the usual chimney entry and opting for the door first
He was clearly ready to sit by the fire and quench his oversized thirst,
“Umbach, where are you, I don’t have all night to take!”
I quickly handed him his glass, hoping the kids would not soon awake,
“What have you been up to Santa, how’s the delivery been?”
Distracted by his Facebook app, Santa was making sure he had checked in,
“Damn this device, I can’t even get a decent 3G network!
Umbach, quickly, what’s your SSID and Wi-Fi password?”
His connectivity now established and social media situation under control
We settled in to discuss the year as his drink began to take hold,
L is now five and for kindergarten getting very tall
He’s started soccer and wrestling to go with gymnastics and karate this fall
T’s in 3rd grade at Haynes where for two more years she’ll stay
She enjoys swimming, gymnastics, soccer, and performing in ballet,
Flowering lotus, one-handed tiger, plank, and half-forward fold
A sampling of yoga poses SecureGirl strikes and somehow manages to hold,
At the crack of dawn healthITjunkie still throws his leg over the bike seat
This marked the 5th year he rode in and raised money for the PMC,
We are always busy at work with more than enough to do
Deb has joined VCE and I’m back at PatientKeeper for round two,
2011 was a great year for skiing, perhaps even our best
With both kids getting stronger, it’ll soon be time for a trip out west,
With the flowers of spring on Mother’s Day came a small family reunion
Both grandmothers and an uncle were present for Taylor’s 1st Communion,
Throughout the summer the kids enjoyed camp at Drumlin and Thoreau
For L it was his first camp experience while T is an old pro,
Before summer ended we managed to spend another week on the Cape
In advance of Hurricane Irene we were able to make our escape,
His mug now empty, my stories long and mercifully complete
Santa decided ‘twas time to saddle up and again hit the street,
We exchanged but a glance knowing the time was right
For Santa knew better than to cross Mrs. Claus on this night,
Then he shouted from his sleigh rising above the line of trees
“Enough Occupy Wall Street, it’s time we Occupy Our Families!”