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Live from HIMSS: Meet the Real Gatekeepers

April 5, 2009
by aguerra
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Takeaways from HIMSS today:

Allowing patients to interact with physicians through messaging and e-mail is a game changer, in terms of increasing patient loyalty and satisfaction. This makes total sense to me, as I'd like nothing more than to never speak the admin at my doctor's practice for the rest of my life. Unfortunately, you see, customer service is not their forte. One problem here: the docs (or someone on their behalf) have to return the messages. Imagine that!

Getting buy-in from practice staff is as important (probably more) than getting buy-in from physicians. Even more, I suspect getting a "green light" from the head doc still doesn't mean you are free and clear, unless you get the previously mentioned admin on board. You see, she is the one that runs the show.

CIOs that want to bring real automation to the hospital know they have to wire up the local docs. The best way to do this is hosting an ambulatory solution in their data center and serving it up to practices nice and easy at a discounted monthly fee (ASP/SaaS), allowing the physicians to pocket the Stimulus money on the back end.

Most failed clinical IT system implementations are due to 1) poor leadership 2) closed culture 3) poor governance. Well, HITECH sure lights a fire under the CEO/CFO, but if they are lacking in motivational techniques or vision, perhaps this the year to anonymously mail them a "Leadership for Dummies" book.

PS: I have heard it mentioned that the states are going to get some money which can be lent to hospitals for HITECH-related implementations. I'm not sure of the details on this, but will keep my ears open.

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Nice post, Anthony.

I would also recommend to everyone interested in this topic, get the audio / pdfs from Dr. Peter Basch's plenary talk at the Physician Symposium on Saturday. It will be available through the HIMSS-endorsed multimedia vendor I previously elaborated access info for (see my HIMSS posts).

Peter is part of the brilliant, seasoned, Clinical HCIT team at MedStar Health, headed by system CIO Catherine S, and system CMIO Gerard B.  (Both of these folks have brilliantly delivered multiple times and contexts in their careers.) I've outlined Peter's talk in my first "Live from HIMSS ... AMDIS" blog post.

In Peter's plenary, which I've watched twice now, by the way, he elaborates the need and potential for improved care coordination.  He offered specific, personal, examples of needed changes in both visit-based care, as well as non-visit-based care.

In a personal communication with him, one-on-one, face-to-face yesterday, he shared that he's been reflecting a lot about transforming both types of encounters, enabled by IT.

One of the things that he offered, that really resonated with me, was the need to establish and agree upon a visit agenda with the patient at the beginning of the encounter, and following up with a review and a written summary at the end of the meeting.  I'm seeing that done more and more in the business world, enabled by the rising fluency with the necessary tools, and the rising complexity of the problems people are dealing with.  (Idle idea:  docs become PMI certified and approach each patient's care as a project .... hmmm.)

When you re-think healthcare as an executive to executive dialogue, where the executive is a patient/person and the provider is a physician/coach, who have both read Drucker, you end up with a much stronger and effective relationship.  Both with visit-based and non-visit-based encounters.

I strongly encourage you, Anthony, to listen to Peter's talk, and consider following up with the appropriate written and published piece.