The following commentaries are the most-read postings from HCI's Blogosphere. To read other postings and leave your comments and questions, visit http://www.healthcare-informatics.com/blogs, register with a username and password, and make your voice heard.
If You Accept a New Job — Please Show Up!!!!Posted on: 9.28.2008 7:23:52 AM Posted by Tim Tolan
It's truly one of the most dreaded realities in the search business. Although this phenomenon happens rarely — it does happen.
Search consultants engage in a retained search assignment and perform the search execution flawlessly. The profiling, sourcing and identification of the perfect candidate for a critical senior level technology opening is performed by the book. The initial screening goes well, the candidate interviews also go well and the candidate is more than just mildly interested. Then it's on to the position questionnaire to further test their commitment and once again — they deliver. They take part in the requisite client-driven psychometric testing with no hesitation whatsoever. Let's not forget the battery of interviews with multiple executives, lunches and dinners and more testing and reference checks to further qualify this seemingly stellar candidate. It's a love affair on both sides of the table. Perfect!
The “trial close” of the candidate goes as planned. You further qualify them and their family on the relocation — everything appears to be “all systems go.” The verbal offer is made and presented to the candidate. Once again — everyone is “all good” and this search appears to be on “final approach” and coming to closure. Finally, the written offer is delivered to the candidate and he/she nods their head north and south and they happily execute the offer letter with enthusiastic anticipation of starting their new career and joining the new organization.
(To read the posting in its entirety, visit http://www.healthcare-informatics.com/tim_tolan.)
How to Multi-task Effectively — Lessons from Playing Tennis with Two BallsPosted on: 10.6.2008 9:28:16 AM Posted by Joe Bormel, M.D., MPH
We all multi-task, that is, do more than one task at a time. If those two things are, say, riding as a passenger, alone, on a train, while doing e-mail, then multi-tasking is great. Multi-tasking can be more productive than the alternative, and, for some of us, a great technology-enabled alternative to spending our time ‘less productively.’
If those two tasks are, say, driving an SUV, while conducting a stressful cell phone call, with that cell phone held to our ear by one of our ‘driving hands’, with four screaming children in the back, and driving up to a complicated intersection with lots of traffic and poor visibility, that's obviously a different story as far as the appropriateness and impact of multi-tasking. I see several SUVs like that daily, coming in the opposite direction. Scary. Most of us agree with Hallowell. In Ned Hallowell's recent book, CrazyBusy: Overstretched, Overbooked, and About to Snap! Strategies for Handling Your Fast-Paced Life, he summarizes as follows, at the end of chapter 5:When what you are doing is important, multi-tasking is a practice to be avoided. Just think of it as playing tennis with two balls.
Many of us either praise or vilify multitasking. We praise it for the real or perceived performance boost we enjoy. We vilify it especially when others are rude to us in human communication. The multi-tasker is turning away from our interaction, 1:1 or a group meeting, or a teleconference (where participants are invisible to each other). Or, the multi-tasker is creating a hazard for all of us as in the SUV example above. Both situations are very common. You might think these behaviors are critical for us to address as leaders and managers.
(To read this posting in its entirety, visit http://www.healthcare-informatics.com/joe_bormel).
Not My JobPosted on: 9.30.2008 8:12:33 AM Posted by Pete Rivera
I read yet another story this past weekend about how “computers” had discharged a patient at a west coast hospital with a diagnosis of pregnancy. The problem was that the patient was an elderly male. We all know that at some point somebody handed this patient a discharge note with this diagnosis. Assuming they actually looked at it, they must have said, “not my job.”
Blaming on the computer system is a nice excuse that the organization can give a patient that does not know any better. It deflects the issue from the true root cause; not taking ownership. This is wrong on so many levels. Let's just look at it from a basic revenue standpoint. Invest in better training, certification processes and quality incentives. This improves quality of information, reduces errors in claims submission, reduces A/R and reduces rework.
So why do we still read about diagnosis errors? With millions at stake, organizational reputations and the need to reduce more critical patient errors, we still see very basic process errors? Can organizations like AHIMA provide certifications for all touch points in the continuum of care or are we always going to read stories about bad computers?
Grady Hospital and the Perils of OutsourcingPosted on: 10.1.2008 12:08:33 PM Posted by Reece Hirsch
On September 23, the Atlanta Journal-Constitution reported that the medical records of patients of Grady Memorial Hospital in Atlanta were made public on the Internet. This security lapse demonstrates the dangers of outsourcing functions involving medical information. Grady outsourced the job of transcribing doctors' notes to a firm in Marietta, Georgia, which in turn outsourced the work to an individual in Nevada, who in turn assigned the work to a firm in India, Primetech Systems.
The India transcription firm inadvertently allowed the medical information of 45 patients to slip onto the Internet. The security breach was discovered by one of Grady's doctors who performed a Google search of this name and found the information on his patients.
For those of you who follow these sorts of things, the Grady Hospital incident may sound alarmingly familiar. In 2003, University of California San Francisco Medical Center suffered a similar sort of security breach that attracted headlines and spurred brief interest in legislation limiting outsourcing of medical information. The UCSF incident involved a medical transcriptionist in Pakistan, far down a chain of subcontractors from the hospital's primary transcription services vendor, who threatened to post patients' records online unless UCSF paid the wages owed to her by one of UCSF's subcontractors.
(To read the posting in its entirety, visit http://www.healthcare-informatics.com/reece_hirsch.)
Live from MGMA: What's Happening with Stark?Posted on: 10.19.2008 9:51:50 PM Posted by Kate Huvane Gamble
This weekend, the Medical Group Management Association (MGMA) conference kicked off in San Diego, a city that I had never visited until now. Since the extent of my knowledge of the city came from the movie Anchorman: The Legend of Ron Burgundy, I was thrilled to get to see it firsthand. So far, I'm very impressed — with both the city and the conference.
One of the hottest topics at MGMA, not surprisingly, is the potential role of the modified Stark Laws in accelerating EMR adoption among physician practices. Specifically, there's a lot of discussion around the findings of a study recently released by the New England Journal of Medicine entitled, “Electronic Health Records in Ambulatory Care — A National Survey of Physicians.” According to the report, just four percent of physicians report having a fully functional EMR in place, while 13 percent say they have a basic system.
The statistics are telling; EMR adoption among physician practices is low and Stark is not having the intended effect in driving the numbers upward. Things need to change, and many are putting the onus on hospital executives to light the proverbial fire. But given the complexities involved in an initiative that unites hospitals with practices, that task is easier said than done.
(To read this posting in its entirety, visit http://www.healthcare-informatics.com/kate_huvane).