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Geek Doctor: Life as Healthcare CIO PDF

418 Pages·2014·4.351 MB·\418
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N11579 ISBN 978-1-938904-55-4 90000 6000 Broken Sound Parkway, NW Suite 300, Boca Raton, FL 33487 711 Third Avenue 9 781938 904554 New York, NY 10017 an informa business www.crcpress.com 2 Park Square, Milton Park www.taylorandfrancisgroup.com Abingdon, Oxon OX14 4RN, UK an informa business GeekDoctor Life as a Healthcare CIO John D. Halamka, MD, MS GeekdoctorV1.indd 1 8/27/15 2:14 PM CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2014 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20160512 International Standard Book Number-13: 978-1-4987-5723-2 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com About the Author John D. Halamka, MD, MS, is a Professor of Medicine at Harvard Medical School, Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), co-Chair of the national HIT Standards Committee, a member of the Massachusetts HIT Council, and a practicing emergency physician. As Chief Information Officer of Beth Israel Deaconess Medical Center, Dr. Halamka is responsible for all clinical, financial, administrative, and academic information technology serving 3,000 doctors, 14,000 employees, and two million patients. As Chairman of NEHEN, he oversees clinical and administrative data exchange in Eastern Massachusetts. As co-Chair of the HIT Standards Committee, he facilitates the process of electronic standards harmonization among stakeholders nationwide. As a member of the Massachusetts HIT Council, Dr. Halamka engages the stakeholders of the Commonwealth to guide the development of a statewide health information exchange. iii GeekdoctorV1.indd 3 8/27/15 2:14 PM iv GeekdoctorV1.indd 4 8/27/15 2:14 PM Contents Foreword by Aneesh Chopra vii Introduction ix Chapter 1: Leading Healthcare IT Organizations 1 Chapter 2: Implementing Electronic Health Records 55 Chapter 3: On Being a Modern CIO 83 Chapter 4: Security and Privacy 141 Chapter 5: Balancing Job and Home Life 165 Chapter 6: Innovation 201 Chapter 7: Patient/Family Engagement and National Healthcare IT Priorities 239 Chapter 8: Responding to Adversity—When Bad Stuff Happens 283 Chapter 9: On Being a Parent, a Son, and a Husband 307 Chapter 10: The Thursday Blog 361 Conclusion 405 Index 407 v GeekdoctorV1.indd 5 8/27/15 2:14 PM vi GeekdoctorV1.indd 6 8/27/15 2:14 PM Foreword By Aneesh Chopra Senior Fellow, Center for American Progress, and Former US Chief Technology Officer (2009-2012) There has never been a better time to be an innovator in healthcare than in the post-HITECH and ACA era. And for entrepreneurs and industry veterans alike, there isn’t a better go-to advisor than Dr. John Halamka. He is among the few health IT leaders with success in three sectors of our economy—public, private, and academic. No matter the role you find yourself playing in the industry, you will surely find inspiration in John Halamka’s words. I certainly have. I first met John while riding the M2 shuttle bus between Boston and Cambridge. We were both graduate students with a shared passion for the (positive) impact technology and innovation could have on the healthcare delivery system. On one of our trips, he shared the story of Careweb, a web-based application he conceived to simplify access to patient data when a caregiver needed it most. His project couldn’t have come at a better time. His employer had recently merged with a neighboring hospital and faced the daunting budgetary challenge of integrating the legacy medical records systems that didn’t interoperate. Vendors at the time had pushed for a full-system replacement, at a cost they simply couldn’t afford. Rather than give up on their integrated vision, Halamka showed the system leaders that they could achieve a great deal of its functional equivalence simply by using Internet-based technologies to publish each legacy system’s data accessible by clinicians at the point of care. His idea worked, and earned him a promotion to serve as health system CIO. That same creative, yet frugal spirit has defined John over the decades since we first met. As our nation’s first Chief Technology Officer, I reunited with vii GeekdoctorV1.indd 7 8/27/15 2:14 PM John to help drive a public policy agenda to upgrade the nation’s health IT infrastructure—not for the sake of adoption, but rather its use as a foundation for achieving health reform, especially the journey towards better population health. No matter the specific topic at hand, Halamka would find a voice for those entrepreneurs seeking a more welcoming path to participate, one with lower barriers that didn’t compromise on standards or quality. His leadership to embrace more participatory channels in policy making from blogs to more virtual meetings opened up the Washington, DC-based policy meetings to everyday frontline workers in healthcare, injecting an implementation spirit in policymaking. In the pages to follow, you will get a better sense of the industry’s current and future challenges, but also an appreciation for how we will confront them. Halamka’s ideas on leadership and family might be your favorite topics in the book, as innovation is often more than the specific technologies or ideas, but rather the context in which they are generated. Regardless, this is a must-read for anyone wishing to apply his or her talents to address our nation’s biggest economic and fiscal challenges. Are we up to the task? If enough of us embrace Halamka’s vision, I’m confident we will be. viii GeekdoctorV1.indd 8 8/27/15 2:14 PM Introduction By John D Halamka, MD, MS Over six years ago, I began writing a daily blog to share my thoughts, experiences, and concerns about the healthcare IT industry. I soon found that my career as a CIO was hard to separate from my life as a human, so my blog evolved into a mixture of work, family, and personal reflections describing my attempt to navigate a rapidly changing world. Many have asked me why I blog. Am I an IT exhibitionist? Do I feel my opinions need to be heard? Am I seeking the attention of my colleagues? No. My reasons are more selfless. Each day I receive more than 1,000 emails including many questions about technology, policy, and government. Although I try to answer each one, it’s much more effective to share the answer publicly so that teams of people can read about my failures, successes, and unsolved problems, avoiding the pitfalls I encountered. CIOs are not the most popular leaders. They are often accused of saying “no” to every new request. The reality is that we’re all humans trying to survive in a resource-constrained work environment. I’m hopeful that my blog illustrates the personal crises, tough choices, and constraints that make the job of the modern CIO nearly impossible. It may be that my colleagues and stakeholders do not agree with my decisions, but the blog illustrates the choices I had, the path I chose, and the reasons why. I’ve said in several blogs that my goal in life is to make a difference. If I can share experiences of my wife’s cancer, my father’s death, and my daughter’s development into a resilient young woman, I’m hopeful that others facing similar emotional events will feel supported. ix GeekdoctorV1.indd 9 8/27/15 2:14 PM

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