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Letter to the Editor

December 1, 2008
by root
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I enjoyed your article (A Living Document) in this month's magazine. However, it reminded me of an issue I have been running into more and more lately. You quoted John Vitalis with a comment about organizations not always retiring older applications with the result being they maintain several systems. I see this regularly and I'm not sure why.

I am the CEO of a small software vendor that focuses in the Labor and Delivery arena. We have a product that adds value to the clinical systems from GE, Philips, Hill-Rom, etc. Because we specialize in extracting data from these systems we have begun to be asked to assist in sunsetting (retiring) these systems when they are replaced. I assumed this effort was a standard practice and included in the integration effort when the new systems were implemented. But it seems to be the rare exception and this surprises me. I have only been working in healthcare for the last three years and prior to that I worked for over twenty years as a systems integrator in several other industries. I can't recall a single instance where we left a legacy system in place, especially one that required significant maintenance expenditures.

We performed five sunsetting engagements already this year, so perhaps this issue is starting to get noticed. But I have to believe that for every system we retire there are hundreds out there sitting in a corner and costing some facility much needed dollars. It seems odd. Perhaps it is worth an article at some point in the future.

If you want more information concerning what I am seeing, or contact information for some of the hospitals we have assisted, please feel free to contact me at any time.

Thanks for your time,

Ross Kayuha, CEO

Strategic Thinking Industries, Columbus, Ohio

The R.N. Factor

Mr. Guerra,

It was interesting to read about the RN Factor as CIOs partner with nurses; this is good and logical.

I would also like to see CIOs partner with laboratorians, which includes pathologists and Medical Technologists. As you note in this edition of your journal, laboratory reports make up 75 percent of the patient record. Laboratorians are in a unique position to understand what is important in capturing laboratory tests, results, and digital images and PACS that are going to make their involvement crucial. As a former laboratory manager, issues that were important to the laboratory were not important or understood by our wonderful programmer (and she was wonderful, efficient and logical), who had a nursing background. Laboratories have different government guidelines (i.e. CLIA ′88) and inspection lists than nurses. These rules must be followed in the laboratory and they extend to samples, processes, reports, and systems. Medical technologists are trained to work with advanced medical and knowledge based systems. It is important that CIOs work with and promote laboratorians into positions of implementation and maintenance of HIS systems and EMR use.

Barbara Blond, MBA, MT (ASCP), Manager

College of American Pathologists, Northfield, Ill.

Healthcare Informatics 2008 December;25(12):18