Tag: Technology

What Healthcare Could Learn From a Technology Company

Screen Shot 2014-08-11 at 9.43.45 AMHealthcare is very different from most other industries. It is fragmented, conservative, highly regulated, and hierarchical. It doesn’t follow most of the usual business rules around supply and demand or consumerism. An important aspect of my role at Microsoft is helping my colleagues at the company understand the many ways that healthcare is different from other “businesses”.

Having said that, there are a lot of things that healthcare could learn from a company like Microsoft or other technology companies. When someone asks me what it’s like to work at Microsoft, I often say what someone told me when I started at the company 13 years ago. Microsoft is like a global colony of ants, working independently and yet together but always “neurally” connected by enabling technologies. At any given moment, I can be connected to any one of my 100,000 fellow workers or tens of thousands of partners with just a couple of clicks or taps on a screen. I have tools that show me who’s available, what they do, what they know, and where they are. I can engage in synchronous or asynchronous communication and collaboration activities with a single member or multiple members of my team using messaging, email, voice, video or multi-party web conferencing. We can use business analytics tools, exchange information, review documents, co-author presentations, and collaborate with our customers and partners anywhere in the world from anywhere we might be. Our business moves, and changes, at the speed of light. It is the rhythm of the industry.

I sometimes wake up in the morning and think, “If only my clinical colleagues could avail themselves of similar tools and technologies how different could healthcare be?” I’ve been using information communications technologies in my daily work for so long that I almost take for granted that this is the way work is done. But I also know that in the real world of healthcare the journey is still quite different. That hit home again last week when I asked my mother’s family doctor for a copy of a report on an imaging study he had ordered. It took five phone calls to make something happen and my only choice was to receive the report via fax machine. Fax machine, really?

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Bad Directions

I love the GPS analogy for health care.  Patients need a GPS for their health, showing them the reality of their past, present, and future health.  The analogy has not only shown me how I want to give care for my patients, it has also given me insight into the pitfalls of automated medical care.

Way back in the days when GPS was new, the rental care company Hertz advertised “NeverLost,” a GPS on your dashboard (if you forked out the extra money for it).  I was asked to give a talk in Oregon, and decided I would try out this cool new technology (since others were picking up my bill).  While I found it overall very useful, there were a couple of times it didn’t work as advertised.

  • I needed a sweatshirt, so  I used the NeverLost for directions to a Wal-Mart.  It worked!  It gave me flawless directions to a Wal-Mart store…in Las Vegas (over 1000 miles away).  I stopped at a gas station and they told me that there was actually a Wal-Mart 1/2 mile down the road.
  • Then, when I was trying to get to Crater Lake, “Never Lost” repeatedly directed me down dirt roads, some of which had trees fallen across their path.  NeverLost was quite perturbed when I didn’t follow its direction, nagging me to make an immediate u-turn back toward the tree in the road.

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When Projects Fail, Should We Fault the Technology?

Last weekend, I saw the film “Up In The Air.”  Ok, so I am a few months behind in my movie viewing.  That is what the Netflix lifestyle does for you.  There is an interesting connected health analogy running through the film and I want to explore it with you in this post.

George Clooney plays the lead character and he spends a lot of time on airplanes.  His company outsources corporate downsizing and his job is to travel the country showing up at a firm to give the bad news to the employees that are being let go.  A much younger woman, who is up and coming at his company, comes up with the brilliant idea of communicating to each individual losing his/her job by videoconference (in the movie, it looks quite a bit like Skype).  The idea is to save on travel costs by having folks like Clooney communicate by video all over the world without leaving their desks.

We first watch Clooney’s character object to the idea.  He believes the idea will never work, claiming that there is a fine art to firing people and you can’t do it over the Internet.  We then watch them perform pilot tests (they are on site at a company being downsized, but do the firings from a different room via video).  In the end, it does not work.   The last scene of the movie is about him being told he must get back on an airplane and travel to a site to practice his craft.  Video just doesn’t cut it when you are getting fired.

Those of you who have been part of connected health program adoption will see the obvious parallels.Continue reading…

The Race is On for the Next Generation of Healthcare

I continue to be amazed at the speed at which the mobility and portability of healthcare is developing. It is readily apparent that the technologies, devices and other innovations that we always knew would transform the delivery, consumption and administration of healthcare—but that always seemed years away—are in fact now here.

It’s kind of like that car commercial from a few years ago that asked why we’ve never actually seen the cool and futuristic concept cars that auto manufacturers have teased us with over the years; except in this case, all of the neat and futuristic stuff is right there just waiting for us to put it to good use. It’s called telemedicine, at the risk of oversimplifying, and combined with the change that has actually been legislated for healthcare over the past year, it’s putting the system on the threshold of an entirely new era.

For example: Remember the dark ages of, say, 1998 or 2000 when patients were given heart monitors to wear and then had to phone their doctor to report the various data? Well, it’s pretty safe to say that we can relegate those to the same time capsule as the VCR and the rotary telephone. Fast forward to today and you’ll find wireless, Bluetooth-enabled devices that can deliver the same information—and a lot more, in fact—in real time, 24/7. How about unlimited geographic boundaries for the delivery of medicine? Think of a lung specialist in Philadelphia rendering his expertise to a patient in rural Australia without leaving the comfort of his desk chair. Tired of being handed a clipboard and then interrogated about your medical history every time you see a new doctor? What if that information—in more breadth and detail than you can remember or are probably even aware of—was delivered to your doctor long before you even showed up for your appointment? And how about if, afterward, it was updated automatically and then followed you to your next specialist appointment?

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Why I Don’t Accept E-mail From Patients

Dr. Wes (a cardiology blogger who all should read) wrote a very compelling post about technology and the bondage it can create for doctors.:

The devaluation of doctors’ time continues unabated.

As we move into our new era of health care delivery with millions more needing physician time (and other health care provider’s time, for that matter) – we’re seeing a powerful force emerge – a subtle marketing of limitless physician availability facilitated by the advance of the electronic medical record, social media, and smart phones.

Doctors, you see, must be always present, always available, always giving

This sounds like dire words, but the degree to which it has resonated around the web among doctors is telling.  He continues:

Increasingly the question becomes – if we choose future doctors on their willingness to sacrifice for others without expectation of appropriate boundaries and compensation – will we be drawing from the same pool of people as the ones who will make the best technically-skilled clinicians? What type of person will enter medicine if they know that their personal life will always take second place to patient care?

Dr. Brian V (long last name, but another one who you all should read) adds his voice to this:Continue reading…

The iPad in Healthcare: A Game Changer?


There have been a lot of discussions on the Net regarding the potential impact of the iPad in the healthcare sector.  At this point, there is very little agreement with some pointing to the ubiquitous nature of the iPhone in healthcare as a foreshadowing of the iPad’s future impact, while others point to the modest uptake of tablet computing platforms as a precursor for minimal impact.

Our 2 cents worth…

We believe the iPad will see the biggest impact in two areas: medical education and patient-clinician communication.

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Program Director Healthcare IT

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Since its inception, the New England Healthcare Institute has been committed to the identification, assessment and promotion of valuable health care technologies with the potential to improve the quality of care while reducing cost. The Fast Assessment and Adoption of Significant Technologies (FAST) initiative, conducted in partnership with the Massachusetts Technology Collaborative, has been at the core of our work to promote innovation in health care and, among others, has resulted in the identification of computerized physician order entry (CPOE) and tele-ICU programs as key elements of health information technology policy at the private, state and federal levels.

Position Summary

NEHI is seeking a Program Director – Technology with rich experience in the health care  technologies to play a critical role in the continued development of NEHI’s portfolio of health care  technology projects. As health care technology receives greater attention for its ability to significantly improve health care quality and lower costs as part of state and national health reform effort, the Program Director – Technology has the opportunity to catapult the promise of FAST to the national  stage and brand NEHI as a national thought leader in the advancement of promising, underused  innovations.

This is a full-time position and an outstanding opportunity for candidates with strong health  information technology experience to work with senior leaders from all across the health care community to drive change in a fast-paced, team-oriented environment. Ideal candidates bring a blend of skills – problem solving, intellectual curiosity, collaboration – to their work at NEHI.  Download job description. (PDF)

Not exactly what athenahealth was looking for

This is not a fun day for athenahealth, and frankly with HIMSS coming up, not a fun time to have such a day. None of this has anything to do with their products or their client services, but late last night the company announced that it’s going to be restating its earnings. You can see a longer discussion on The but essentially it appears that athenahealth has been amortizing its installation costs over one year whereas they ought to have been doing it over more years. The net result is that they’ll have to restate some earnings and are going to miss the next earnings reporting deadline. The stock is off roughly 12% today.


What’s been happening is that the new CFO (Timothy Adams) has come in and cleaned house, and not liked what some of the old CFO (Carl Byers who moved to Chile!) had been doing. Long term this clean up is probably good news. The company is still operationally profitable (we assume!), and its business of running the back office and increasingly front offices of doctors using a combination of technology and forklifts/sweat remains a great way of both routinizing their businesses and aggregating data for overall process improvement.

So better to get any financial “irregularities” cleared out now and be more conservative. But while other than the shareholders (and the coming lawsuits) it probably doesn’t matter much, this may per chance slow down Jonathan Bush a touch next week. Or maybe not. We’ll see….

Health 2.0: Beneath the Hype, There’s Cause for Real Hope

Health 2.0 is a trend accompanied by both buzz and buzzwords. That worries some advocates for the poor, under-served and just plain old and sick. Will those groups be left behind in the latest information revolution?

The potential positives of the Web-as-health-care platform for interactive health care services could be seen in two full days of presentations and discussions at a recent meeting in San Francisco, called the Health 2.0 Conference. Still, a certain Silicon Valley sensibility remained: widgets for weight control were much more likely to target the calorie count of cappuccinos than corn dogs.

Yet the real question is not whether Health 2.0 arrives clothed in hype; of course it does. The capitalistic ritual of “new and improved” is similar for software and soapsuds. The important issue is whether the substance of Health 2.0 can help deliver health care services significantly more efficiently and effectively while reducing disparities. Look beneath the hype and you can see it’s already starting to do so.Continue reading…

HIMSS Parties, and a little more

Next week the health IT world descends on Atlanta which means a lot of chat, lots of meetings and lots of parties. You’ll be seeing the results of my interviews on THCB next week.

But meanwhile more importantly—the party schedule. So far I’m signed up on Monday for the MEDecision party (mostly because it’s in the aquarium), the HISTalkparty (in which you try to spot the mysterious MrHISTalk and Inga) at Max Lagers. I’ll likely be wearing a sash.

For Tuesday night I’ve been asked to give a special shout out to the FierceHealthIT party. Apparently this one will be huge but there’s room for more. It’s at the World of Coca-Cola, and I'm not sure if you have to bring your own rum. Sign up here

Finally, there’s a new party on Tuesday called HITMen which has an interesting group of cats & dogs on its host committee….although probably only worth going after the palavah is over (unless you like sitting through award ceremonies).

Of course there’s a large chance that I’ll miss all of these but there are two sessions I won’t be missing.

Monday at 2pm in room C201 I’ll be one of the bloggers to meet in the Meet the Bloggers session. It’ll be a good chance for me to argue in public with Val Jones.

And Tuesday at 1pm the ever wonderful Jane Sarasohn-Kahn and I will be presenting on Health 2.0 & Participatory Medicine in Georgia Ballroom 1.

This does all assume I can get out of France despite the air traffic controllers strike! Hope to see you in Atlanta.


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