Newsham’s Last Note… for Now! Keeping On!
Posted Friday May 22, 2015 2:30 PM - MacVicar-Elliott, RoseMary
Thirty-four blogs later and I’ve really grown to like this and other parts of the social media scene. Minimal structure, a license to sort of ignore grammar, communication dictums be dammed, rants and views encouraged – this all fits a CEO’s wish to escape the rigors of correctness once in a while. And I’ve even tweeted the occasional 140-character message, not to mention regularly accepting and using the professional’s network – LinkedIn. I will keep on following, with delight, the Glenns, Mikes, Andres, Wills and other social mediaistas in our health informatics (HI) and healthcare community and wait, with anticipation, for the next social media craze or tool to sweep our world.
That’s the first keeping on – keeping on connecting.
Second is the keeping on learning. Just this week, in the second of a series of international e-Health meetings that I can’t even tell anyone about – don’t you just love or hate when that’s said, but it’s true sometimes – I picked up on the value of research-based systematic reviews. They are the very methodological summaries of research studies on a topic of keen interest to policy makers and others.
Did you know that 13 of 22 studies evaluated internally-developed systems? Only nine studies evaluated commercial health information technology systems and only two studies showing decreased utilization! Well, this is the stuff of systematic reviews and the basis for policy, guidelines and leading practices, all used in a very structured way to inform governments, clinicians and e-Health leaders everywhere. These are new learnings for me and there is more to come.
Keeping on contributing will also be part of my future. With my love of alliteration, my professional interests will continue to include strategy, standards, safety and supporting the entering and emerging HI professional along with the emerging HI “C” suite professional. Serving, sharing and engaging in HI has been a passion in my life and I don’t see that changing in the years ahead.
Another keeping on is having fun. On a total change of topic and based on my Globe and Mail reading this week – you know everything I know is from The Globe -- this week was Letterman’s last show. Paul Schaffer, his band leader summed up his view of the future like this:
“I feel like I’ve had a lot of fun. How can you keep having ALL the fun?
Eventually you’ve got to let others have some fun.”
Well, I’ve had an incredible lot of fun in my job and career. Leading COACH has put me in touch with so many great and totally enjoyable people, events, evenings, office laughs and conversations. While it is time to share some of that fun among others, I intend to keep on having fun. Meeting current colleagues and new friends on the West Coast or any coast, or in any fun city, wine country or piazza, I am sure to keep on having enjoyable times, at work and at play.
Facing the Future
Finally, in another newspaper, an article about the last “Mad Men” show underscored how nostalgia couldn’t save Don Draper. Nor will it save me … or us, the COACH community. While we are enjoying our anniversary celebration immensely and the well-deserved recognition of leaders and contributors over the last 40 years, we can’t go back, nor do we want to. This was spelled out in the article: “We can’t just spend our time trying to revisit past glories, either personally, professionally or politically. Sometimes you just need to put on your sunglasses and face the glare (or bright sun, as I think of it) of the future head on.” That’s my mantra going forward and I hope it is part of yours too. We have a tremendous future ahead for HI in Canada, for COACH, for our emerging and upcoming leaders and for each of us in our career and associating together.
So, yes, this is my last Newsham’s Notes as CEO, but I’ll be keeping on and I know that all of my friends and colleagues across Canada and globally will keep on … connecting, learning, contributing, having fun and looking to a great future.
My warmest personal appreciation and farewell to you all.
Last Updated Friday May 22, 2015 3:58 PM - MacVicar-Elliott, RoseMary
The End of the Beginning – A Maturing of Health Informatics
Posted Friday March 6, 2015 12:30 PM - MacVicar-Elliott, RoseMary
Three days of some of the best scientific papers on health informatics (HI) and what have I learned? We’re reaching a tipping point, a long yearned for level, an acceptance and yet … we’ve just really begun to effectively integrate our world of HI into the everyday working lives of our health and care system. We have the pieces, we’ve completed many projects, we’ve got the foundations, we’ve learned much from the experiences of more than a decade of major HI growth and we’re now ready to apply where we’ve been and what we know to make some truly remarkable advances.
Lofty words and just words, but three days at the ITCH 2015 Conference, delivered by the University of Victoria School of Health Information Science, have molded my thinking further on what we have gained and what is left to accomplish. Let me share a few thoughts from those days.
- First is a reminder of the value of scientific endeavor. Methodologically sound, evidence-based, data rich, analytical and openly debated study, built on the review and summation of related studies, provides an extra layer of knowledge to our oft-targeted experiential and implementation-based presentations at conferences. While what works is always applicable, what is evidenced by research is equally important. Where do some of our new ideas and possibilities come from – such as the linkages of ethnographic methods to building a culture of patient safety, as a triangulated method for HIT fault analysis or as an electronic pill bottle? These are but some of the researched possibilities to add to our experience-based knowledge.
- HI is a field of scientific study. Masters and PhD research and papers from around the globe demonstrate the acceptance of HI as a discipline. Informatics, we know, is a discipline and we will watch for even more acknowledgement of that field from major internationally recognized institutions -- think libraries moving to informatics organizations. The growing cadre of internationally recognized HI leaders from a large number of academic institutions building an ever expanding body of researched knowledge, demonstrates the contribution of the discipline of HI. Congratulations to our academic leadership in Canada and beyond for achieving so much for HI.
- A major way of knowing what we’ve accomplished and what is yet to be done, comes from research. Dr. David Bates shared the results of many studies for patient safety that give rise to the current and continued, at minimum, 10% rate of adverse events across healthcare systems. And increasingly, studies point to rates in the range of 15-25%. While we are gaining some ground in making patient care safer – with coverage systems, sensor-based monitoring, increasing decision support, efficient registries and patient-centred toolkits – we have so much yet to do. And increasing studies point to lessor, but still dangerous rates of adverse events resulting from HIT implementation and use. Research reinforces that systems add to safety and systems need to be safer.
- A study on the many workarounds in the use of passwords was an amusing, yet hard-hitting analysis of how much more we need to do to address cyber security. How many of us have a file named ‘passwords’ on our smart phone or computer? I do. Well, I’ve faked out the name better I think … but ….
- A study into the extended use of open software tools for EMRs provided an architectural demonstration of how to effectively connect personal health records to EMRs. It can and … should be done.
- And finally, a keynote address by Catherine Claiter-Larsen provided all of us with a glimpse into the next generation of regional EHRs (sometimes known as Health Information Exchanges) and what it will take to get us there. The change she shared from a project view to an integrated ongoing work view was distinct and exciting. Acknowledging how far Island Health has come in the use of electronic record components and the foundations that were in place, but knowing the achievement of top levels of adoption and use would take a permanent, planned integration of HI into the everyday fabric of her health regions’ governance, management, quality processes and clinical workflow takes maturity of leadership and purpose. HI leaders, many as graduates of HI programs, have that maturity, but equally acknowledge they are really just at the beginning of embedding the needed HI systems into the health and care of their population. It’s not a project, it’s our work.
- And … the public media is getting it. Well, starting to get it. The Sunday Victoria Times Colonist ran an editorial on what has been done, but more importantly, on what is left to be done, with really no choice but to get on with uniform, complete “e” records across the island. When our public media, our newspapers, our media Twitter leaders, our Infoway ads aired during the national CBC newscasts and so many within HI, all bring HI issues and opportunities to the public, we are maturing HI. And with so much more to do, we are just beginning to enable the true value of integrated digital health embedded into all health and care.
There’s some of my research for the week. What other evidence, data and analysis do you have to share?
Last Updated Friday March 6, 2015 12:31 PM - MacVicar-Elliott, RoseMary
Changes: Looking Back – So Much, Looking Ahead – Much More
Posted Tuesday January 20, 2015 4:30 PM - MacVicar-Elliott, RoseMary
In a recent 40th anniversary preparations review, I browsed through past COACH Journals…my how some things have changed. Joining the COACH Board in the late 90s was a new guy from Red Deer, complete with beard. Many HI professionals profiled in the Journal were certainly younger, without any gray hair. The information highway was being planned, the Internet was born, the PC and Microsoft were at the forefront of technology and computers and information systems were expanding into the integrated world of HI. For myself, for sure, and for most everyone, even with recent decade starting dates in HI and with COACH, I’m sure you feel much has changed. And you’re right.
The 40th anniversary of COACH is a great time to celebrate, reflect and look ahead. And a source of much of our revelling will be on the change we all observe. While the old axioms on change quite apply, it’s quite instructive to consider the depth and scope of change.
- “Our” healthcare community has moved from a focus on computers in hospitals, through to hospital information systems, the health information highway and now to e-records for provider and patient alike. Therein lies four decades of transition and transformation, not to mention trial and tribulation.
- The users of our work have moved from the finance, payroll and HR offices to admitting and health records departments, nurses on wards, techs in Lab, DI and Pharmacy, physicians on rounds, clinicians everywhere, community health, all of primary and specialized care and patients and yes, to the public, the family and the neighbor next door. What a change that has been.
- The data has grown immensely – from administrative data to patient identification data, from basic patient information to results and orders, to discharge summaries, to meds, history and health summary data, to complete clinical records, to all medical data, to home monitoring data and now to your personal genomic sequencing data.
- Technology has changed….somewhat. (Understatement here!!) We have moved from mainframe to minicomputer to server, from washing machine-sized disk drives to solid state and flash drives to the cloud, from PC to laptop to tablet, from large cell phones to palm pilots to PDAs, from Walkman to iPod, from 80-column card to keyboard to touch to hand wave (dating myself severely here).
- The standards have grown from EBCDID, ASCII, COBOL Batch and real-time processing to XML and HL7v1/2, to modelling frameworks and patient identifiers, to the MIS and the ACHI framework, to COACH’s security guidelines (first edition 1985), ICD 9 and 10 to READ codes and to SNOMED, to HL7v3 and now to open EHR, FHIR, ISO and HL7 standards galore and ISO’s Joint Initiative Council of health informatics SDOs.
Well, that’s just a smattering of what’s changed in 40 years in our industry and community. And within the COACH world itself, much has changed. From the beginnings led by Steve Huesing and his founding colleagues, to the events, programs and member services led by our many past presidents and boards, to the 40 – yes, FORTY— great conferences showcasing the products and vendors that have made such a difference in what HI professionals can deliver, COACH has been the backbone of Canadian HI for four decades.
I know someone now wants to hear all the things that “haven’t changed” over many years, and such is quite right. And much of what hasn’t changed comes from the people side, if I may say so. We’ve learned, we’ve grown, we still make mistakes and we still need further training and education, along with continued excellence in management and leadership.
Looking ahead, well, there are huge and exciting changes to come. We often only get glimpses of these changes – after all, if we knew, we’d all be rich. But those glimpses come in many ways. I’ve shared some of my glimpses of what’s to come in past blogs - Adding the “P” to our HI Community, Learnings from Down Under, The Culture of eSafety is Building: Join In!! and Digital Health Week and the Increasingly Integrated ‘e’ of Healthcare. I’m watching with great anticipation for how we are going to design, develop and adapt our future in HI.
And for those of you who track entertainment and consumer electronics, you can catch another view of the immensity of change into the future. Consider the recent Vegas CES I read about the communications android (a droid host or receptionist coming to an office near you … someday), the ring for gesture-based action initiation, the smart mirror painting digital effects on your face in the mirror, the pocket printer the size of a Rubik’s Cube, the electronic basketball and the 3D doodle pen – for 3D art creations or any other MacGuyver-like gadget.
The future of how healthcare may take advantage of the technical, data and user interface changes is really open and far reaching. I, for one, am really looking forward to how I can use the “e” in my health and personal world in the years ahead.
And that brings me back to the guy from Red Deer who joined COACH in 1999. I am changing too, with wonderful reflection, acknowledgement and pride on what we’ve accomplished together and with exciting opportunity and anticipation in turning over a strong and solid organization to the incoming CEO. I’ve been so fortunate to stand, build and pass on the legacy of so very many that have come before me and with me in leading, volunteering and working with COACH. A simple but extremely heartfelt thank you to all.
And I’m not done yet. We’ve lots to do this spring, lots to celebrate and an amazing future to look forward to. Join me as we celebrate COACH’s 40th anniversary and 40 years of COACH and e-Health Conferences.
Last Updated Wednesday January 21, 2015 10:11 AM - MacVicar-Elliott, RoseMary
Blog 31 - Christmas Season Wish List - for HI Professionals (HIPs)
Posted Friday December 12, 2014 2:00 PM - MacVicar-Elliott, RoseMary
Snow, hockey, eggnog coffees, the countdown and holiday season parties all have us thinking…what’s on those wish lists? Well! Here in HIPerville, with all the young and not quite young HIPers sending their Christmas lists to Santa. I happened to find a group of sharp EPs willing to hack their way to a new App, that allows me to get a second feed of Santa’s email from many HIPs. Read on for some of the Christmas wish lists that I found!
- Many HIPs in HIPerville wishing for 2 days, or even 2 hours without any email messages.
- Michael Green wishing for a small, well, ok, he said moderate special sack…filled with million dollar bills.
- Vendors asking for their order pipeline to fill to overflowing.
- Will, Glenn, Michael and Pat asking to be in the top 5 trending on Twitter for one day every month. (Or was that every week?)
- Leon, Susanne, Dave, Linda, Scott and several other consultants asking for not one, not two, but three shiny new RFPs in their email sock on Christmas morning, all due on Jan. 5, of course.
- COACH management team, Grant, Shannon and Linda, asking for no new, "Why don’t we…" ideas from Don…for one month at least. (I could almost make it easy on Santa…Yes? But no.)
- Brent, David and others at CIHI wishing for really, really big, big data to fill their DAD and all those other hungry and growing databases.
- Clinicians everywhere asking for easy access to patient data, with minimal disruption to their workflow, and e-agencies everywhere asking Santa to help make that true every day (with minimal pain and difficulty in doing such…pretty please).
- Trevor and Lynne wishing for interoperability specs for all.
- Lydia, Marc, Dianne, Barry, Sandy, Ken and so many other CIOs asking for one day with nothing but happy users, staff and bosses.
- Shannon, Brent, Kent, Shelagh, Cassie, Elaine, Lynn, Mike and Leon wishing for rain for e-Health 2015 for the 2,000+ delegates, to keep them all indoors, on the show floor and at the sessions.
- Elaine and Brendan, well, simply certification now and always tops on their list.
- Grant and Elizabeth asking for an eSafety Guideline in every HIPs Christmas stocking
- COACH’s staff, Amanda, RoseMary, Cheryl, Christina, Carina and Kathleen, asking for 1,000 new members. (OK, I made that one up, had too!) But really, they asked Santa for more chocolate chip cookie and caramel popcorn days at the office.
- Jennifer, Kendall, Neil, Ed, Christina and Andrea wishing for an overflowing batch of telehealth, mobile health and virtual health scientific papers for GT2015.
- EPs wishing for jobs, jobs, jobs, and a posting list filled to overflowing every week.
- Government CIOs asking for one week without any briefings due.
- Shelagh wishing for a new jingle to replace the "Here, There and Everywhere" earworm of the better health together promo.
- COACH Board members wishing for shorter Board reports from Don & Co. (I could help Santa there too) and overflowing memberships for COACH.
- Other HIPs in HIPerville asking for an extra 2 hours in every day or was that 2 extra days in every week?
Well that’s a smattering of the wish lists I found through that special App. And sorry, it was a one-time App use only. Self-destructed after my one quick use…Santa’s rule.
But I want to add one big wish from me to Santa. I wish for every health informatics professional in our awesome Canadian community that you each have the best of health, the fulfillment of career, the passions of life, the love of family and friends, the success of contributing and the warmth of enjoyment at whatever makes your day. For me, right now, it’s sitting here in Starbucks enjoying writing this blog, my 31st, and a hot London Fog on a wintry day. Blessings to all this holiday season.
Last Updated Friday December 12, 2014 2:05 PM - MacVicar-Elliott, RoseMary
Digital Health Week and the Increasingly Integrated 'e' of Healthcare
Posted Tuesday November 11, 2014 12:00 PM - MacVicar-Elliott, RoseMary
DIGITAL HEALTH WEEK. Yes, we have our own week! I’d like to say we’ve arrived on some level, but that may be precipitous. The real message of #digitalhealthweek is that we are an increasingly accepted and integral part of the health system serving patients and providers. Digital health is an integrated service and enabler to better care.
With opportunities to hear from patients, frontline staff, top executives and clinicians, from varying parts of the country, I hear some great perspectives on digital health. Patient stories are well shared by many in our community. Canada Health Infoway’s Jennifer Zelmer provided a great telehealth focused video that shared a family story on care for their son and his care follow-up between their home in northern Ontario and the Sick Kids surgeon in Toronto. And that’s just one of a vast number of interactions that happen as patients connect to caregivers through our ‘e’ health care world.
Click on the image to watch the #digitalhealthweek video, "Better Health Together: Places."
Providers are engaging using ‘e’ at an ever increasing rate. You all know the national and provincial EMR adoption figures; I won’t repeat those, but even greater integration is happening, for example, through e-visits and e-consults that are an increasing emphasis and reality. Dr. Ed Brown in his Canadian Club speech last week noted the 2,800 teledermatology e-consults through OTN and the work ahead by OMD on a full provincial e-consult program. A personal note, if I may, on providers using ‘e’. I had the recent benefit of an off-hours email interaction with my physician that was hugely needed, reassuring and helpful, including confirmation of my EHR availability where needed. Again, your examples of the ability to connect with clinicians, share personal health history and update record information from your wearable monitor are all becoming integral to our health care system. The more we collectively use digital health, the more we will support and see the benefits and the more the apps, tools and systems become an accepted part of health care’s daily work and services.
And our leaders are leading. One of our top (someone noted “uber”) CIOs identified integration as operating as if a single entity, with strategic solutions, usable standards, reduced complexity and shared services. I think many in the “C” suite would agree and indeed are making such happen. He further noted that healthcare CIOs have moved from a corporate/regional mandate to that of a shared service mandate with such integrated service examples like Alberta Health Services, the SIMS Partnership, HITS Nova Scotia and others. The CIO of Southlake Regional Health Centre shared some of their actions in integrating innovation and solutions to a set of current “e” needs, through their healthcare ecosphere venture. Jim Carroll talked about the hospital being a network. Acute care centres increasingly see themselves as virtual hospitals using all of the technologies necessary to enable remote medical monitoring, virtual visits, and community care, in the community.
When it comes to hearing about “e” at our education and conference events, well, it’s not a standalone or buried topic. This years’ eHealthAchieve demonstrated the integrated view with the ‘e’ sessions listed throughout the entire program. Digital Health is part of many, if not most health conference pages and presentations, in one form or another. Exhibit floors provide eHealth vendors and associate products and services in most every aisle and section.
And these are only the early parts of the Digital Health story building on the work of the past years that has seen a transformation in the infrastructure and access for digital solutions. Think repositories, registries, shared EHRs, EMRs, CPOE, etc., all being integrated in support of clinical care. The current ‘e’ story is building in mobile and consumer solutions, analytics driving personalized medicine and participatory care.
And throughout it all are you, the health informatics professionals, planning, strategizing, designing, delivering, managing and caring for the systems and solutions to make care better for patients and providers. As one Canadian and a sometimes patient, my thanks to each of you for contributing, collaborating and connecting to bring about integrated digital health care. Oh and raise a toast with your next morning cup of coffee to everyone on your team in this first ever Digital Health Week.
I’d be very interested to hear how you are making Digital Health work as a HI professional, along with your greatest challenges & achievements. Please post your story below or email me the details at firstname.lastname@example.org.
Last Updated Tuesday November 11, 2014 3:14 PM - MacVicar-Elliott, RoseMary