There are obviously a lot more recommended practices when doing an RFP, but these three are always good to consider. I tried to provide guidance that applies to both IT and equipment purchases.
On Friday, May 10, I once again have the pleasure of co-chairing the Medical Imaging Informatics and Teleradiology (MIIT) conference at Liuna Station in Hamilton, ON.
The program for the 14th annual MIIT meeting is stellar, we have a record number of sponsors, and—thanks to lower registration fees and new group discounts—many people are already signed up to attend.
- AI Strategy of CAR – Roger Tam will enlighten us on the Canadian Association of Radiologists’ strategy for AI.
- Cloud Services for Machine Learning and Analytics – Patrick Kling will reveal how cloud-based solutions can address the challenge of managing large volumes of data.
- Patient-Centered Radiology – Dr. Tessa Cook (@asset25)will provide insight into their progress on this topic at UPenn.
- Collecting Data to Facilitate Change – Dr. Alex Towbin of Cincinnati Children’s Hospital (@CincyKidsRad) will show us how to use data to support change management.
- Panel on the Future of DIRs in Canada – In this interactive session, we will discover what has been accomplished with Diagnostic Imaging Repositories (DIRs) in Ontario, and what’s next. I will moderate a panel with leaders from SWODIN and HDIRS.
- Practical Guide to making AI a Reality – Brad Genereaux (@IntegratorBrad), with broad experience working in hospitals, industry, standards committees, and technology, will help attendees prepare for this new area.
- Healthcare IT Standards – Kevin O’Donnell, a veteran of healthcare standards development and MIIT, will provide an overview of developments within the DICOM and HL7 standards, and IHE.
- ClinicalConnect – Dale Anderson will provide an update on this application (@ClinicalConnect), used by many organizations in the local region.
If you can attend, I am sure you will find the event educational. There are lots of opportunities to interact with our speakers and sponsors. If you are not from the region, you may find a weekend getaway to the nearby Niagara on the Lake wine region enjoyable.
And don’t forget to follow MIIT (@MIIT_Canada) on Twitter!
The SIIM 2018 Annual Meeting in Washington D.C. is just around the corner (May 31 to June 2). I look forward to seeing many friends, sharing ideas, and learning. I will be involved in number of sessions this year. Here is a preview.
Thursday, May 31 | 9:45 am – 10:45 am | Annapolis 1
In this roundtable session, participants will discuss how to best prepare for, develop, and issue an RFP, as well as how to analyze and grade the responses. We will also discuss how to best prepare for, and support, contract negotiations with a vendor.
Friday, June 1 | 9:45 am – 10:45 am | Cherry Blossom Ballroom
Depending on your organization’s goals and scale of enterprise, the options available to you for an image archive can vary. In this debate-style session, we will explore the merits of using a Vendor Neutral Archive (VNA) vs. an archive provided as part of an Enterprise PACS. I am moderating the session.
Saturday, June 2 | 12:45 pm – 2:45 pm | Baltimore 3/4/5
Participants that sign up for this learning lab (limited seats available) will work hands-on with experts to learn how to perform clear and compelling financial analysis. Two lab exercises—one focused on assessing cloud-based vs. on-premises image archive storage, and another on the IT investment required for rolling out the enterprise imaging solution to a newly acquired facility—will be worked on in teams. Each team will share their work with the other near the end of the session. Lab assistants will be on-hand to assist. Participants must bring a laptop or tablet with Microsoft Excel installed.
“All the king’s horses and all the king’s men…”
Deconstructing a PACS into discrete, enterprise-scale components seems to be all the rage for many organizations. But, like many things in life, taking something apart is often far easier than putting the pieces back together (and getting something that works).
At this year’s RSNA meeting, I will chair a session on PACS Reconstruction (RCC24) on Mon 27-Nov-2017 from 2:30 to 4:00 pm CT that will focus on the challenges and opportunities of building an integrated enterprise-wide imaging solution for diagnostic review and clinical access.
Following my introduction of core concepts, we will hear from Charlene Tomaselli, Director of Medical Imaging IT at Johns Hopkins and Bob Coleman, Senior Director of Enterprise Imaging Informatics at MaineHealth on their progress and vision to providing an integrated imaging solution for their enterprises.
We will have a panel Q&A with the audience to share lessons learned and discuss how to best prepare for changes.
This article interviews several people in the trenches, and on the front lines, of imaging IT planning, integration and management in today’s Consolidated Enterprise.
Critical to success are:
- Imaging and clinical informatics knowledge (how to get all those MRNs to link, how to manage orders and results across facilities)
- Solution flexibility/scalability (having systems that can expand, as needed, at reasonable cost…even temporarily during a data migration)
- Viable financial models (shared cost allocations based on volumes)
- Policy development (for assigning user permissions and setting data quality and retention targets)
- Human resource planning (what roles and skills are needed post-consolidation)
- Partnerships with suppliers (to ensure that system expansion and data consolidation will succeed at predictable costs)
Organizations that prepare for consolidation and invest effort in these areas will survive—and even thrive—in the never ending healthcare provider merger and acquisition race.
This article has some great observations and sound bites, including the mention of a hospital promoting the lack of an EMR in their employee recruiting ad as a reason to work there.
Health IT is often touted by IT professionals (myself included) as necessary for the digitization, consolidation, aggregation, integration, access, and exchange of a patient’s information.
The article describes how the introduction of an anti-social third party—a computer with an EMR on it—affects the physician-patient relationship.
It also talks about the current state-of-the-art for user experience design within EMR systems.
In an example of a near fatal medical error involving an EMR, it mentions a phenomena often known as “alert fatigue”, whereby a system provides so many alerts, they become ignored (or disabled). IT professionals may have experienced this in poorly configured system monitoring solutions.
See this article for an more in depth explanation of the problem that caused the medical error.
In talking with organizations that are in the throws of EMR adoption, they are focused on data migration, interface development, pre-canned training, roll outs, organization redesign, and cost management. There is little time for reflection on user satisfaction or efficiency. Vendors trying to sell their solutions into one of these organizations often find it difficult, as resources are scarce and the motivation to add yet another system to manage/interface is low. Budget holders are reluctant to spend money on solutions if their pending EMR promises to have similar capabilities (even if this claim is yet unproven).
When I encounter an organization that is well past their EMR implementation, they are typically looking for ways to optimize their use of the EMR. This may involve configuration changes to the EMR or changes to their workflow, but often involves the use of add-on solutions to fill gaps, or “hacks” to provide alternatives to the user interfaces provided by the EMR to their users.
The above observation on how organizations differ based on where they are in their EMR adoption, makes me think about this excerpt from the article…
“In the 1990s, Erik Brynjolfsson, a management professor at M.I.T., described “the productivity paradox” of information technology, the lag between the adoption of technology and the realization of productivity gains. Unleashing the power of computerization depends on two keys, like a safe-deposit box: the technology itself, but also changes in the work force and culture.”
I think that where Brynjolfsson is recommending that both “keys” are considered and used in parallel—at least where EMRs are concerned—we are more often than not using them serially. First, get the EMR in as quickly as possible (to save costs and hopefully to reap the rewards promised sooner), and only after we better understand what we actually bought and have, start to figure out how to do it right.
There may be no better way, given that healthcare institutions can’t just stop and “reboot” themselves with a system and staff that is optimized. But, one can imagine that living and working in that period following an EMR implementation, and before the age of enlightened optimization, can be painful and frustrating (and even dangerous, as the article shows).
So, maybe promoting the lack of an EMR may attract those people tired or afraid of the post-EMR, pre-optimization period, as there they can be happy. For a while.