Geek Doctor: Life as Healthcare CIO

418 Pages·2016·4.162 MB·English

by  John D. Halamka

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