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Perna G. A Hazy Outlook for Cloud Computing. Healthcare Informatics. December 29, 2011.
“With healthcare data set to spike over the next few years due to the advent of electronic health records (EHRs) and the ongoing digitization of diagnostic images, a new debate has emerged in the industry over the value of the cloud. While a considerable number of healthcare providers are turning to cloud computing as an alternative to traditional servers for storage purposes, others remain skeptical.
Cloud computing gives providers the opportunity to store data on a virtual server, and can be either public (operated by a third party vendor) or private (kept strictly in-house); or it can be created as a hybrid, using a combination of both public and private clouds. There’s no doubt that the cloud has become a trendy idea to solve storage-related cost issues. Consulting firms like Accenture (Chicago, Ill.) say cloud computing can save up to 50 percent of a provider’s hosting costs on an annual basis.
However, a look inside the front lines of the healthcare industry shows that CIOs and other technology leaders in healthcare aren’t fully sold on the concept. Questions about its security and reliability have cropped up while a multitude of other, more pressing IT issues have kept cloud development on the backburner. Even its cost savings have come into question. In short, when it comes to the cloud, there seems to be more doubt than certainty.”
Tugend A. Forget Networking. How to Be a Connector. Entrepreneur. January 29, 2012.
“We all know people like them, people who seem to know everyone. They’re always able to help — or if they can’t, they know someone who can. You meet them for the first time and in 15 minutes, you’re talking with them like you’re childhood friends. They’re successful, smart and funny, with a likable touch of self-deprecation. And they’re interested in everything.
Who are they? Connectors…
Traits such as energy, insatiable curiosity and a willingness to take chances seem to be the common thread among connectors — as well as an insistence that connecting is not the same as networking.
‘Networking I see as a means to an end,’ says Jill Leiderman, executive producer of the late-night show Jimmy Kimmel Live. But connecting, she explains, is about using a genuine love of meeting people and making friends to engage and assist one another.”
Erickson BJ. Experience with importation of electronic images into the medical record from physical media. J Digit Imag. 2011;24(4):694-699.
[Abstract] The purpose of this article is to describe a system we developed for importing images on compact discs (CDs) from external imaging departments into our clinical image viewing system, and to report on key metrics regarding veracity of information seen on the CDs. We recommend careful attention to the process of CD importation because of the error rate we have seen. We developed a system and process for importing images on CD into our EMR. The importation system scans the CD for digital imaging and communications in medicine (DICOM) images, and collects all patient information seen. That information is presented to the patient for verification. Once validated, the image data is copied into our clinical viewing system. The importation system includes facilities for collecting instances of incorrect data. About 90% of images are now exchanged between our healthcare enterprise and other entities via CD. Data for the wrong patient (e.g., the wrong CD) is seen in about 0.1% of cases, and a similar number of CDs have data for more than one patient on the CD(s) the patient bring to our facility. Most data are now exchanged via DICOM files. DICOM images burned onto CD media are now commonly used for image exchange. However, applications to import DICOM images are not enough. One must implement a process to assure high confidence that the data imported belongs to the patient you are importing.
Hullett J and Simms S. A Cloud-Based Approach for Cardiac Image Sharing: Improving Cath Lab Operations. Cath Lab Digest. November 2011.
“Cloud-based image sharing platforms are increasingly becoming more prevalent in medicine. Cardiac cath labs can turn to this new approach for sending and receiving images to end their previous reliance on physical CDs and shipping. These new solutions come with an assortment of major benefits. Transmitting imaging studies online allows cath labs to reduce costs while improving both the quality of care provided as well as their own ability to attract the right referrals for their facility. Ultimately online image transfer systems allow physicians to build better and deeper referral networks, which in turn means increased volumes and a more open platform for collaboration.
Many cath labs still utilize the archaic method of burning and shipping physical CDs through FedEx or a courier. Most who have operated within this workflow can speak to the inherent inefficiencies of this system. Although many drawbacks can be found, there are key three limitations of this old image sharing method:
1.CD transfers are slow and stagnant.
2.CD transfers limit referral volume and quality.
3.CD transfers come with too high of a price.”
Michael S. FDA Crafting Regs for Mobile Medical Apps. Diagnostic Imaging. November 7, 2011.
“As FDA officials consider the more than 130 industry comments on draft regulations for mobile medical apps, they are trying to strike a balance between encouraging development and ensuring safety.
‘We are very supportive in terms of where mobile technology will take us [in] healthcare,’ said Bakul Patel, an FDA policy advisor who spoke last week at the American College of Radiology’s inaugural summit on informatics in Washington, DC.
The agency published its draft guidance in July and accepted comments through last month. The guidance outlined what kinds of medical apps would be regulated by the FDA, such as those that can be used as an accessory to a medical device or those that transform a mobile computer and convert it to a medical device would ideally fall under their purview, Patel said.
Patel said many in the industry understand the intent of the regulations, but have requested more clarity.”
McAfee A. What Every CEO Needs to Know About the Cloud. Harvard Business Review. November 2011.
“In 2010 an IBM survey of more than 1,500 CEOs worldwide revealed a troubling gap: Close to 80% of them believed their environment would grow much more complex in the coming years, but fewer than half thought their companies were well equipped to deal with this shift. The survey team called it ‘the largest leadership challenge identified in eight years of research.’
Unfortunately, the information technology infrastructure at many large companies only makes this challenge more difficult. Their technology environments actually impede their ability to sense change and respond quickly. While there is no simple fix for this problem, help is at hand in the form of cloud computing, a new suite of digital tools and approaches.
Cloud computing is a sharp departure from the status quo. Today most companies own their software and hardware and keep them ‘on premise’ in data centers and other specialized facilities. With cloud computing, in contrast, companies lease their digital assets, and their employees don’t know the location of the computers, data centers, applications, and databases that they’re using. These resources are just ‘in the cloud’ somewhere.”
Everse G. Eight Ways to Communicate Your Strategy More Effectively. Harvard Business Review. August 22, 2011.
“A frustrated CEO recently shared with me that her employees had lost their edge. They were internally focused, their speed-to-market was down, and they couldn’t find a good balance between serving customers well while making healthy margins. The result was slow progress against the company strategy and an inability to profitably deliver on the value proposition. She had attempted to motivate employees and be clear about the strategy, but she was falling short and was looking for answers on what to do next. The solution in many cases is to overhaul internal communications strategies in order to convince employees of the authenticity, importance, and relevance of their company’s purpose and strategic goals. Here are just a few communications approaches that will help you effectively reach your employees and encourage behaviors that advance your strategy and improve your results.”
Young J. Google-Like Word Searches of Medical Records May Boost Patient Safety. Bloomberg. August 23, 2011.
“Google-like searches of hospital medical records using English words and phrases found more patient injuries than the numerical billing codes used to rate quality of care, pointing toward a better way to highlight safety issues, a study found.
Researchers from the U.S. Department of Veterans Affairs reviewing patient records at six VA medical centers turned up 12 times as many cases of pneumonia and twice as many incidents of kidney failure and sepsis, a blood infection, when they used text searches instead of numeric codes linked to reimbursements…
Administrative and billing codes weren’t designed to measure quality of care, said Nancy Foster, the vice president of quality and patient safety policy at the Chicago-based American Hospital Association, a trade group. The most accurate information should be used to hold hospitals accountable, with English text searches being preferable, she said.”
Welling RD, Azene EM, Kalia V, et al. White paper report of the 2010 RAD-AID conference on international radiology for developing countries: identifying sustainable strategies for imaging services in the developing world. J Am Coll Radiol. 2011 August;8(8):556-562.
[Abstract] The 2010 RAD-AID Conference on International Radiology for Developing Countries was a multidisciplinary meeting to discuss data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services reduce health care quality. The theme of this year’s conference was sustainability, with a focus on establishing and maintaining imaging services in resource-limited regions. Conference presenters and participants identified 4 important components of sustainability: (1) sustainable financing models for radiology development, (2) integration of radiology and public health, (3) sustainable clinical models and technology solutions for resource-limited regions, and (4) education and training of both developing and developed world health care personnel.
Bond A. Peer feedback cuts doctors’ over-use of tests. Thomson Reuters 2011.
“Feedback from fellow physicians helped doctors do fewer unnecessary tests on newly diagnosed prostate cancer patients in a study aimed at improving health care quality and consistency.
Coaching on the most current guidelines led doctors to cut in half the number of expensive CT scans and bone scans they ordered for low-risk patients, sparing them costs and potential side effects.
‘The study is a great example of a new solution for an old problem,’ said Dr. David C. Miller, the lead researcher and a urologist at the University of Michigan. ‘Physicians are at the heart of the solution…’
‘It’s a lot more meaningful for doctors to hear about changes in their behavior from their own peers than from an insurance agent or a policy maker.’”
Herman S. Clinical Decision Support in Medical Imaging. ADVANCE for Imaging & Radiation Oncology. August 8, 2011.
“Clinical decision support (CDS) solutions are used widely across health care environments and bring value from both clinical and business perspectives…
Research has long supported pharmacy’s use of decision support to provide alerts for adverse drug interactions. In radiology, CDS use is less common and research is limited, yet there is some movement.
‘Decision support systems for advanced imaging are being implemented with increased frequency and are mandated under some new governmental health care initiatives,’ according to a January 2011 study published in the Journal of the American College of Radiology.
In this study, researchers at Virginia Mason Medical Center evaluated evidence-based CDS built into ordering systems for selected high-volume imaging procedures. Results showed that the use of CDS was associated with substantial decreases in the overall imaging volumes (all diagnoses) for lumbar MRI, head MRI, and sinus CT.”
Grant K. Knowledge management, an enduring but confusing fashion. Electronic Journal of Knowledge Management. April 2011;9(2)117-131.
[Abstract] Knowledge Management has been a subject of significant management interest for some 15 years. During that time it has been subjected to a variety of criticisms including the argument that it is little more than a “fad” — something that catches management‟s attention for a while and then fades away because of a lack of sustainability. It has been compared to other major management fads such as quality circles and business process re-engineering. This paper examines the discipline of Knowledge Management (KM) through the lens of management fashion theory. It demonstrates that KM is not a fad and that it has become an enduring management activity. Management Fashion Theory (Abrahamson and Fairchild, 1999) is an extension of Rogers‟ Theory of Diffusion of Innovations (Rogers, 2003), that takes a skeptical view of business innovations, viewing the discourse about and the diffusion of innovations as a cultural phenomenon rather than a rational decision making process. After a brief introduction to the field of Knowledge Management (KM), a review of the theories of Diffusion of Innovations and Management Fashion is presented, along with a description of the methodology used to apply Management Fashion Theory to the discourse on KM. Bibliometric and content analysis techniques are used to examine publications and discourse in the field from 1990 to 2009. The analysis of discourse on KM demonstrates a significant period of “latency” from the late 1980s to 1994, during which foundational ideas and precursors to KM appear. Then a rapid growth period is identified, from 1995-2001 during which KM becomes an innovation of interest to most major organizations. Finally, it appears that discourse has settled at a steady state, with no decline apparent. However, detailed analysis has also indentified a potential conflict between the interests of practitioners and researchers, with a separation of the discourse into distinct groups that may have inconsistent views on what is or is not “Knowledge Management”. In summary, this paper presents a comprehensive analysis of the evolution of discourse on KM. It provides bibliometric evidence that there has been a sustained interest in KM that is quite unlike that of other popular management themes over the last 30 years. It raises some questions about the relevance of some of the research being carried out.
Schmitt J. Meet Your New Boss: the Competition. Business Week. July 26, 2011.
“It’s only natural that businesses recruit employees from rivals. So what can you expect when one of those opponents winds up as your boss?
The two men couldn’t be more different. Your old boss burrowed into spreadsheets and reports, keeping his own counsel and rarely venturing among the rank and file (let alone making eye contact). The job demands had left him furrowed, stooped, and dour. You nicknamed him ‘MaGoo’ and derided his speeches as ‘nature’s answer to Lunesta.’ But you don’t know what to make of his replacement. This guy hops planes for ‘listening tours.’ He chats with staff on Facebook and on Twitter. He is young, hip, upbeat, and technically savvy. A month ago he was poaching your accounts. Now he’s your boss. The old guard already hates him. You love him for that.
The guy sure talks a great game. He claims you’re building a new kind of company. Instead of warning of tipping points, he espouses joy and candor. His communications always end the same way—with a reminder that ‘this is our moment’ and how he believes in you. Nonetheless, you feel wary. You haven’t forgotten those slanders and sleazy deals that emanated from his former employer. That’s always on your minds: Was this man the brains behind them? Many of your fellow employees had immigrated to this company to get away from the cutthroat culture over there. Now he has followed them. Time to wonder: Will you become like them—or is he trying to escape all that, too?”
Coyne KP, Coyne ST. Seven steps to better brainstorming. McKinsey Quarterly. March 2011.
“Companies run on good ideas. From R&D groups seeking pipelines of innovative new products to ops teams probing for time-saving process improvements to CEOs searching for that next growth opportunity—all senior managers want to generate better and more creative ideas consistently in the teams they form, participate in, and manage.
Yet all senior managers, at some point, experience the pain of pursuing new ideas by way of traditional brainstorming sessions—still the most common method of using groups to generate ideas at companies around the world. The scene is familiar: a group of people, often chosen largely for political reasons, begins by listening passively as a moderator (often an outsider who knows little about your business) urges you to ‘Get creative!’ and ‘Think outside the box!’ and cheerfully reminds you that ‘There are no bad ideas!’
The result? Some attendees remain stone-faced throughout the day, others contribute sporadically, and a few loudly dominate the session with their pet ideas. Ideas pop up randomly—some intriguing, many preposterous—but because the session has no structure, little momentum builds around any of them. At session’s end, the group trundles off with a hazy idea of what, if anything, will happen next. ‘Now we can get back to real work,’ some whisper.
It doesn’t have to be like this. We’ve led or observed 200 projects over the past decade at more than 150 companies in industries ranging from retailing and education to banking and communications. That experience has helped us develop a practical approach that captures the energy typically wasted in a traditional brainstorming session and steers it in a more productive direction. The trick is to leverage the way people actually think and work in creative problem-solving situations.
We call our approach ‘brainsteering,’ and while it requires more preparation than traditional brainstorming, the results are worthwhile: better ideas in business situations as diverse as inventing new products and services, attracting new customers, designing more efficient business processes, or reducing costs, among others.”
Weissman JS, Hasnain-Wynia R. Advancing Health Care Equity through Improved Data Collection. N Engl J Med. June 16, 2011.
“Health care reform’s promise will not be realized if it fails to reduce racial and ethnic disparities in care. The first step toward monitoring, identifying, and targeting the underlying causes of disparities is for health care organizations to collect and analyze data that adequately describe their populations. No single entity has the capacity to analyze disparities for the entire country, and one of the largest and most comprehensive sources of utilization — health insurance claims — lacks basic demographic data on the race and ethnic background of enrollees. It is therefore worthwhile to examine the status of data collection and future options…
Recent national legislation may lead to some improvements. The section on ‘meaningful use’ in the Health Information Technology for Economic and Clinical Health (HITECH) Act requires physicians to record the race or ethnic background for at least half their patients in order to be eligible for incentives related to implementing electronic health records. Eventually, health information exchanges may be able to transmit this information to insurance companies, but it will be years before such exchanges are operational, and no data will be collected from people who don’t use health care services.”
