Why Doctors and their Leaders Need to Embrace Technology -- And How

Let's face it, a lot of doctors hate their computers. After reading through the article published by the New Yorker, I couldn't help but notice a lot of similarities in the various stories of different health professionals (nurses, health admins, neurosurgeons, etc) that are struggling with the adoption of new technologies in their fields. There seemed to be quite a few similar themes and patterns with each story. More and more organizations are adopting various technologies, and those technologies are rapidly advancing and always changing, so it can definitely be hard to keep up. However, instead of getting frustrated as an end user or forcing technology onto your organization "because it's the next greatest thing" as a leader -- you should have a strategy in place as well as an open mind.

Technology is a powerful thing and if implemented or used improperly, it can have adverse effects.  However, when done the right way, it can be life-changing, especially in the field of health and medicine. I've compiled a list of health professional's generalized complaints and frustrations, and how embracing technology can actually help solve the very problems the users seem to be encountering.

"A 2016 study found that physicians spend 2 hours doing computer work for every hour spent face to face with a patient growing the average workday to 11.5 hours"

Listen, no one wants an 11.5 work day. No one wants to have to do monotonous tasks that seem trivial or repetitive. That's not what technology is here to do. One of technology's main roles in your organization should be to automate and essentially increase productivity. For this, it starts at the top. The new technologies need to be rolled out properly by the organization's leaders. When introducing a new technology to your company, make sure there is significant training beforehand and deploy the technology in small groups. Start with one department and learn about their challenges and successes and build from there. Make sure there are plenty of resources and a support team for them to reference once completely immersed into using this technology on a regular basis. For example, one thing Managed Solution does for new Office 365 users is offer a Customer Immersion Experience (CIE). This is a hands-on discovery of the Microsoft Office tools. It's not a demo. It's not a presentation. We allow the new users to use dummy devices with real-life scenarios built into the devices and they experience it as if it was their own. We also only do this in groups of up to 12 users for one-on-one interaction. With this kind of implementation, we see user adoption increase incredibly versus those who don't. Oftentimes, when migrating and not opting for a CIE, we have customers come back and ask for it months later to ensure their teams are using the tools correctly.

"During the implementation phase, IT folks logged 27,000 help desk tickets"

Now that is a whole lot of support tickets! How could this have been prevented? Again, it begins with the training and deployment of the new systems, services, and tools. I can't emphasize enough to take things slowly and adopt one shiny new toy at a time. Migrate your data and information in phases. Test, test, test and then test again before rolling new software out to an entire organization or even an entire department, depending on the size. Start with small groups. As a leader of an organization or department, it's important to get feedback from those actually using the new software. How they use it in their day to day is going to be vastly different than a VP or CEO or someone in another department. That said, as a leader be sure to get input and consistently check in for feedback. As a user, make your challenges known as early as possible to reduce the probability of others running into the same one. At the end of the day, this technology should increase the users' productivity, not become a burden so it's important to communicate both challenges (and successes) to share with others.

"The new software/tool/etc allows multiple organizations/people to modify information you've already input."

There might not be anything more frustrating than doing your work and having someone else completely override it, whether intentionally (no matter if it was good intentions) or accidentally. There's no good in having to do the same work twice, especially when it's taking up hours of your time. To avoid this, you need to make sure you have identity management implemented.  Identity management determines whether a user has access to systems, but also sets the level of access and permissions a user has on a particular system. For instance, a user may be authorized to access a system but be restricted from some of its components. Another example is that your administrative assistant could have access to view certain documents or files, but only you can edit them. There becomes a chain of hierarchy and roles that allow for certain rights and access. Lastly, any modifications or changes should be backed up and stored somewhere in an archive that is easily referenceable to those who would need it.

Employees getting burnt out by technology is no surprise but shouldn't be so common. Doctors and other healthcare professionals are spending too much time trying to input data or find the right data, and not enough time with their patients, family or friends. With the work they are doing, if anyone deserves a work/life balance, it's them. We need to make sure we're equipping them with the right training, the right deployment schedule, the right resources and support throughout the technology adoption.  This could all start with building out the right technology roadmap. A technology roadmap or an IT roadmap can look one year or even three years ahead to plan for the adoption of new infrastructure, systems, and technologies. It outlines budget, timeline, adoption phases and more. Having this all outlined in paper and agreed upon by leadership helps to ensure success in the long run.

While in the short-term, there will be many headaches, especially for generations who didn't grow up using email, AOL Instant Messenger or Facebook. However, aren't most things challenging when we first start them? Change is never easy - it's not supposed to be. We need change. We thrive on change. Albert Einstein once said, "Insanity is doing the same thing over and over again expecting different results." Without acceptance for change, there cannot be growth. What would happen if we always gave up when things were hard?

It comes down to focusing on the long game. Create a deployment schedule. Implement training. Have multiple training sessions. Roll out things in small doses. Just like some doctors have to wean some patients off medication, they need to be slowly introduced onto technology and increase their technology dosage. Little by little, increase the functionality, increase the availability of new software and they can more easily adapt.

Lastly, I'd like to end on a positive note. Instead of looking at all the negative that these technological advancements may be bringing to the world of healthcare, let's look at positives: You can now remotely check vital signs of a patient recovering from surgery who's still at the hospital while you're on the go.

Technology is a mighty powerful thing, but technology is empowered by people. Make sure you're empowering your people to leverage the right technologies and offering the right resources to digitally transform your business, leading to growth and success.

Meet the Tech Exec: Charles Podesta, CIO, UCI Health

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MEET THE TECH EXEC
Charles Podesta
CIO
UCI Health

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To download the full magazine and read the full interviews, click here.
Over thirty years experience in Information Technology for Healthcare, the last eighteen years as a Chief Information Officer, Podesta has worked for Academic Medical Centers, Health Systems and Community Hospitals. He is currently the CIO for University of California Irvine Health. Previous to this engagement Podesta was SVP & CIO of Fletcher Allen Healthcare, a large academic medical center and health system in Burlington, VT.
Other positions included SVP & CIO at Caritas Christi Health Care, now Steward Health in eastern MA, CIO at Berkshire Health Systems, Pittsfield, MA, Director of IS and Interim CIO for Baystate Health Systems in Springfield, MA. And prior to that, leadership positions at St Vincent Hospital, Worcester, MA; UMASS/Memorial, Worcester, MA and Magee-Women’s Hospital, Pittsburgh, PA.
Over the years, Podesta has made numerous presentations at national conferences and is quoted widely in healthcare publications on a variety of IT topics including Epic’s Community Connect Program.

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What did you want to grow up to be when you were a kid?
I was interested in being a major-league baseball player or being in a band, and I currently play spoons for bands so I kind of made it. Maybe not with a real instrument but it’s fun, you can check out my YouTube account to learn more -just type in Chuck Podesta Spoons.
What innovative projects are you the CIO focusing on this year to support the vison and mission of UC Irvine Health?
We're currently working on a huge strategic project with UC San Diego, we're changing our electronic health records from all scripts base to the Epic system. UC San Diego has already migrated to this system and will be hosting us, which is saving us a lot of money being we won't have to build a system from scratch. We're doing it as a collaboration with UCSD so from a strategy perspective we'll have two independent academic medical centers on a single instance of that electronic health record. Patients that we both serve will be in a single database so when physicians access that information they could see patient data from anywhere in the UCSD or UCI network. We're moving to population value based care and strategically working together on joint programs serving areas that may be underserviced from a standpoint of health. Having a single electronic record between the two organizations really supports that effort both in Orange County and in San Diego.
We go live in November with this big project but parallel to that we’re looking at a single support model from an IT perspective between San Diego and UCI because if we have a single instance of the electronic health record we don't really need two IT teams supporting it separately. We're going through a process looking at where we can share and centralize resources with the implementation. It's pretty exciting, we'll be the first two academic medical centers on the same instance of electronic health record in the United States when we go live. It's never been done before. We're making the single support model scalable so other UCs could potentially take advantage of that as well to reduce costs. It's more about IT following strategy, making sure you create the IT components to follow your business strategy and being a key partner throughout the process.
What's your take on Public Cloud and how have you as the CIO improved academic healthcare workflows due to cloud technology?
I just had a keynote speaking engagement on a panel at a recent cloud conference. If you look outside of healthcare, yes everyone is moving to the cloud. The issue with healthcare has always been with the Protected Health Information (PHI) and as CIOs we have been nervous about moving that information to a cloud based system with the risk of having a breach. That's always been in the back of our minds with the thought of how fast you really should move to the cloud. Some of the technologies we use aren't architected for the cloud, which is another reason we've been slow to adopt, but now it's starting to rapidly move in that direction.
When we first started working on a recent analytics project, we had a large new data warehouse on premise that we just recently moved to the cloud. With HIPAA protection in place the savings are tremendous because now you're able to scale up or down and easily add more storage when its needed, making it a lot less expensive. We're seeing huge benefits from that right now so what I think you'll see is more and more movement going forward. Every time we look at a new
application we always look to see if we can run it from the cloud, either private cloud or public cloud. Now with all the security protection public cloud vendors are all moving in that direction, getting into the healthcare side of the business.
With our Epic project, both UCSD and UCI are having Epic host us on their private cloud at their large datacenter headquarters in Wisconsin. Electronic health will technically be in the cloud. If you talk to 100 CIOs you'll get 50% that express wanting to move to the cloud and the other 50% that aren't ready to move, I think we are at a crossroads. It's about timing, a few of us should try it; as we get a year or two down the road and see the savings without breaches the fear will be eliminated and others will get more comfortable.
What innovative projects are you the CIO focusing on this year to support the vison and mission of UC Irvine Health?
We're working with a start-up company doing quite a bit on the analytics side. We're building what we like to call an ecosystem with a new data warehouse. We like to call it an ecosystem because it's a living, breathing entity instead of thinking of it as a being a black box that receives information from all various sources like electronic health records or lab systems, mapping it to some data warehouse that you must update once a day for reporting. That worked in the past with Microsoft SQL but we're moving into a more native format wherever it comes from whether it be social media, IoTs sensor information, and again the electronic health record, tracking the data in real time and being able to use it right away. This way you don't have a bunch of people mapping the information, you've created a self-service environment. We now have dashboard graphics to display as data is refreshing in real time on a second by second basics, so they could start to use the data for research or operations. That's why we call it an ecosystem because what is looks like right now is different from what it looks like 30 seconds from now based on the data that its ingesting.
We're starting to do a lot of subscriptions with social media, it's amazing what's out there. Just from turning your location services on it's unbelievable with the amount of information being sent to the cloud. We could look at patients and see how they are using applications and how they prefer to collaborate, email vs. text messaging. If you’re going after a specific demographic with a message you could now see how you should target them based on the analytics.
With these analytics, we’re trying to create a personal experience designed to target a personal persona based on the data as a corporation group. Design an experience for patients without having to ask, we just know from the data insights. Part of how you get reimbursed is based on the patient experience. You're going to see a lot of Chief Experience Officers coming in to drive that experience into the healthcare space. We want patients to have a satisfying experience when they’re spending time to visit our facilitates.
What are your specific hiring challenges if any?
It's a very competitive area, Epic is one of the leading electronic healthcare systems along with Cerner, they probably take up 80% of market share between the two of them. Once you get on that specific platform it's hard to find talented professionals with those specialized skills and once they get the certifications in the product they become highly marketed, so consulting companies are recruiting your best employees. You need to get creative with some strategies, our UCI
undergraduate and graduate school is filled with smart engineers, as well as excellent students with math, science and even English majors. When you hire millennials right out of college and get them certified on Epic they get up to speed quickly because you’re trying to hire the best and brightest. I've had success managing and measuring success during my tenure at the University of Vermont where we would hire two or three millennials per year. Managing them is different. They produce very productive work but have a work hard, play hard attitude so actually work better and faster without a deadline. They enjoy completing projects so they could move on to the next thing, rather than waiting until the last minute when a deadline is provided. New graduates are also compensated at a lower pay scale so you may lose them after a few years as their pay scale goes up, if you manage them well they work very well. Don't get me wrong you also need to recruit employees with more experience, you should just leverage millennials as a strategic way to recruit.
What kind of messaging is coming down from key executives about their partnership with IT?
With the Epic implementation, our joint collaboration has been huge, we have 700 people across the organization working on this project. I just did a big presentation to our executive team addressing where we are on progress and the benefits in each of the areas whether it be revenue cycle or clinical, they are all looking for efficiencies within their area based on the new electronic health record. This is making nurses and physicians more productive while the revenue cycle is calculating charges we may be currenting losing so getting up in revenue by utilizing technology to empower the business going forward is key. Right now, we have a bunch of different systems but Epic will provide us with a single system that integrates efficiencies so everyone can really see where the information is flowing. That’s what they’re looking for right now. Our collaboration with UCSD is huge for us as they've been live on the system for a while now so they're educating us on how they are using it best.
If you won the lottery, what would you do?
I would start a foundation, build a school somewhere either in the United States in a poverty-stricken area or outside of the United States. That's something I've been thinking about anyway. I’m passionate about running marathons that support charities, so I'm at a stage in my life where I want to give back. I've been blessed with a wonderful family and life so I would definitely want to start a foundation that would give back in some way.
Has the idea of using cloud changed your mindset of outsourcing IT?
We still mainly handle IT inhouse but outsourcing, which we now refer to more as managed services has its place for certain things if you can get creative around that. I think outsourcing to other countries will slow down more, especially in healthcare. You really need to look at your core competencies and consider what you need to accomplish for them. We are outsourcing our datacenter to the cloud and letting those experts manage it as it’s not our core competency so I look at that as smart outsourcing.
If you could give guidance to any CIO about how they position their careers what would you tell them?
It’s interesting because it depends what they actually want to accomplish. Do they want to be a CIO or VP from an Operational standpoint? There is a place for both and depending on your work style you need to sit down and consider how you prefer managing and leading. Ask yourself the question, am I tactical and results driven when leading people day to day or do I like to sit back and look at what should be happening a year from now and take more of a strategic standpoint. Then you need to consider what both entail. I’ve seen employees get promoted to a VP or Director role and do extremely well there because they are hands on and could still patriciate in strategy but really excel in the day to day operations. I would say that role is 30% strategic and 70% technical from an operational standpoint. I’ve seen employees excel in these roles and get promoted to CIO and get lost, finding it hard to make that leap and start thinking in a unique way. You need to be introspective about yourself and really consider if you want that change because both roles are very important so if you excel as a Director or VP you could be very successful staying in that role rather than taking the leap. When I was in that role and interested in becoming a CIO I got a mentor who I asked to coach me in understanding the differences of the roles, so if you are ready for that leap there are defendable ways to achieve that but my initial advice would be to consider what role you would be more successful in as they are both very important.
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Meet the Tech Exec: Jason Fischer, CIO, PIH Health

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MEET THE TECH EXEC
Jason Fischer
CIO
PIH Health

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To download the full magazine and read the full interviews, click here.
Jason Fischer is the Chief Information Officer for PIH Health Hospital, an IDS with 2 acute care facilities, home health, over 20 medical office locations, and a Managed Services organization.
Prior to joining PIH Health, Jason spent 7 years as the Director of Applications and Revenue Cycle at CHOC Children’s. During that time, he led the Information Systems application teams, project management office, development, revenue cycle and hospital coding departments. In addition, he was the executive sponsor for both the ICD 10 and Meaningful Use programs for the health system. Most recently, he was instrumental in the opening of a new patient care tower, tripling the size of the previous patient care facility and bringing in many new ancillary service lines. In addition, he assisted CHOC in achieving HIMSS level 6, a testament to the organizations goals for improving safety, minimizing errors, and prioritizing IT implementations.
Prior to CHOC Children’s, Jason gained broad industry experience as an auditor and management consultant with Ernst & Young LLP and Accenture. During his 10 years, he consulted with many of the leading health care systems in the country.
Jason earned his bachelor’s degree in Accounting and Biology from Syracuse University in New York. He is a lean six sigma green belt and CPA/accounting professional. 

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If you could have a superpower, what would it be?  

The ability to see into the future. With the healthcare IT landscape constantly changing, there are many shifts in resources that we need to consider, both in terms of people and technology, to be as impactful as possible. So if we were able to see into the future that would be great.

What’s the #1 area of focus CIO’s should concentrate on?  

In healthcare right now, the number one area of focus is security.  With all the breaches that are coming into the healthcare space for patient data and with the increased focus on exploited vulnerability, security is a top priority.  We've been focusing on everything from laptops to network vulnerabilities from an IT standpoint but the most important and biggest risk for us and any organization are the people. We have what we call a Phishing exercise where we send messages out to the organization on a quarterly basis to see who accepts the messages by launching an attachment or clicking on a web link.  This enables us to educate and notify those users thereafter in an effort to reduce continued risk. Because our entry point is our people through email or through other means regardless of how widely deployed our security technology is , any one associate or clinician can pose risk to the organization.

What’s your take on public cloud?  

We use the public cloud for a couple of different purposes right now and are working with a few outsourced vendors.  I think it’s a great, cost effective model for supporting healthcare IT, however I think that there are some challenges with risk and exposure, potentially HIPAA violations associated with data sharing that may take place outside of our control. The cloud has proven to be cost effective and beneficial from a growth standpoint and the public cloud decreases the need from our data center.  But the focus really needs to start with reviewing the risks when we select the vendor. We need to consider if the cost benefit outweigh the risk burden.  As one example, our human resources application suite is cloud based along with a few other niche applications.

Do you feel IT still carries the title of a cost center rather than revenue driver? 

I don't see IT necessarily as revenue driver but I also don’t see it as just a cost center. We are 100% a business partner within the PIH Health organization. That's how this organization sees it and that’s how I see it. We model our strategic plan from the organization’s strategic plan, roadmap and vision, which of course equates to growth, revenue, and quality in the healthcare space. So, while we're not necessarily a revenue driver we absolutely support, and have enabling technologies to support, those business models and the growth of the organization.   

What are you (the CIO) doing to support innovation in the company and its own organization to deliver better solutions?  

PIH Health is focused on mobile technologies around telemedicine, analytics and clinical processes.  Telehealth is a current initiative we're starting up for the stroke service line. We have a mobile solution that we are going to deploy here in the next 30 days for our physicians in the in-patient setting to access labs, radiology results and orders all through their mobile phones.  For management across the organization, we've deployed a mobile application which essentially is an analytics scorecard, where you can view key financial and performance indicators across our two hospitals.  We are also focusing on analytics in general. Analytics in the healthcare industry can be improved. In addition to security, we have a huge focus on using all of this data that we've aggregated for many years now in a meaningful way to help drive business decisions whether they be in the finance space addressing what we should invest in and where we should grow, or in the quality space around patient disease classifications, whether it be asthmatics or diabetics. We have been collecting data (both clinical and financial) for many years and are now starting to use it to drive business decisions across the enterprise.
The other thing that I think is really exciting for us, you may even experience this in your personal life as well, we started deploying a patient engagement kiosk in our physician practices.  Upon arrival, it allows patients to check in without having to wait in line or complete paperwork, or as an option a “pre-visit” check in from a web based platform in the comfort of your own home.  The whole purpose of this is to expedite your patient visit so you can spend more time with your care provider as opposed to completing paperwork that you then have to hand over to a person who has to enter that information into the system before you could be seen. Another innovative approach is our interoperability platform. These allow us to share patient data with other facilities so they could have visibility into your problems, your allergies, medicines and so on. Data sharing is another focus in the healthcare industry right now. We are participating in a closed program with seven health systems in the Los Angeles area as well as a major payer to exchange data across our patient base. The purpose is really two-fold and includes increasing the quality of care for all patients whom are part of that population and managing costs.
  We run on average about 50 projects through our department at any point in time, and these are not just IT projects.  They are organizational initiatives, so we have a lot of examples of things we are doing to advance the business. The whole purpose is creating efficiencies where we can in departments, as well as to determine how we grow and establish ourselves in the community as a care provider that has the highest level of quality and is the most efficient.

We are hearing so much about the internet of things – what does or could the internet of things for your business look like?  

The one thing that comes to mind is connectivity of devices, patient monitoring devices or infusion pumps are currently separate from our IT systems. When you start connecting through IoT we're sending patient data to those devices and they are sending clinical data back to our electronic medical record.  We are just beginning to plan for this level of integration and are researching the security concerns to ensure a safe and efficient connection. As an industry, I think we need to get past the security concerns with some safeguards. The vendors we are working with in that space that support those technologies right now are working collaboratively with us and our EMR vendor toward integration.

Are there any hiring challenges?  

Yes, every day. The market for healthcare IT specifically, for good talent is challenging. It is really hard to find the right fit with the right skill set. PIH Health has open positions all the time. We try to fill them, but it's that balance of finding senior-level experience who have niche knowledge of a particular electronic medical record platform or a particular technology. These people are really hard to find because they are sought after so you see salaries increasing as well, which is good for the economy.  Our department on-site has about 100 full-time employees. We have an off-site support service in Buena Park and 30-40 full-time employees that we utilize in India, so we have a 24/7 IT support team.

What did you want to grow up to be when you were a kid?   

An orthopedic surgeon. I became more interested in the business of healthcare and had a heavy interest in IT. I balanced that out by keeping my focus in healthcare.

What kind of messaging is coming down from the CEO/Key Executives about their partnership with IT?  What are they expecting you to look at?  

IT is seen as a business partner. We provide shared services to the entire organization. Our senior leaders understand that to achieve our goals around revenue growth and efficiency,  technology and a technology team that partners with them is integral. That is why we model our IT strategic plan off of the organization’s plan. We're in the third year right now of a plan that we're going to refresh for another three years based on where the organization’s priorities and roadmap take us. From a service line perspective, growth prospective, efficiency and cost perspective, as well strategic advancement, the message is clear that IT needs to be a partner. We're also looking at the offset of those investments as well. Whether it be in people or other areas where total cost of ownership can be decreased, it is important to constantly evaluate the benefits of any IT investment.

Has the idea of using cloud changed your mindset of using outsourced IT rather than keeping in house?  

I don't think so. As I mentioned earlier when we discussed public cloud, we have our HR suite, we also have a private cloud that we outsource for database support of our EMR platform that services this organization. I'm all for it where it makes sense and where we can show a proven track record. We still have two data centers full of server stacks that must be on-site right now for applications we host on-site.  But I do see it as a cost reduction when utilizing larger businesses like our EMR vendors who have larger datacenters that end up costing less. So I fully support it when it makes sense for the business, it’s never an all or nothing decision.

If you won the lottery what would you do?  

I would probably still work. I enjoy what I do here at PIH Health, I enjoy the operations side and more so the growth, so I would probably just continue with the status quo.

If you could give guidance to any CIO, IT Manager Director about how they position their careers what would you tell them?  

I grew up in IT moving through some of the ranks and had an opportunity at different stages of my career to broaden my horizon and not just be niche focused. For any individual who is interested in growing into a larger management role in IT, I would absolutely suggest creating both breadth and depth to get a good feel for what the department has responsibility for and how it runs.  Getting a good feel for what works and what doesn’t is very important. You get to develop your own opinions and your own management style as you grow. I think it’s a lot easier to manage a broader department if you have greater insight into the overall scope of what that department does, so my advice would be rather than being more linear and niche focused, be a little bit broader throughout your career.

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Why do healthcare professionals choose Windows 10 devices?

Allergan embraces growth pharma model, accelerates business with the Microsoft Secure Productive Enterprise

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By Ron Markezich as written on blogs.office.com
With 22 acquisitions in the past five years, it’s easy to see how Allergan is a leading exponent of the new “Growth Pharma” business model. Expanding its diversified portfolio of branded and generic pharmaceuticals by acquiring companies like Botox and Zeltiq Aesthetics, Allergan is pursuing a rigorous growth strategy, rather than investing heavily in R&D. This approach, known in the industry as “open science,” sees the company enriching its intellectual property by acquiring new talent, promising new products and partnering closely with many external stakeholders. It requires an agile, IT-enabled workplace to pull off the rapid employee onboarding and a rich culture of teamwork and creativity to make this strategy work. At the same time, it’s critically important for Allergan to ensure the security of its IP and to remain compliant in this highly regulated industry. So, it’s great news that Allergan chose the Secure Productive Enterprise solution to enable this disruptive way of doing business in the pharmaceutical industry.
Here’s what CIO Sean Lennon has to say about the organization’s decision to facilitate a new culture of work at Allergan that securely enables teamwork and creativity for all workers with the help of the Secure Productive Enterprise solution:
“As Allergan continues to build its global portfolio of products and services, it’s our role in IT to enable the company’s scalability. That’s why we chose the Microsoft Secure Productive Enterprise, because it allows me to deliver a secure technology experience that drives creativity, collaboration and teamwork for the business. So, while employees are working more collaboratively and are empowered to innovate with immediate access to all the tools they need—Office 365, Enterprise Mobility + Security and Windows 10 Enterprise—I’m also saving money by consolidating our IT landscape and reducing the burden of on-premises maintenance. It’s always a challenge to maintain a lean IT organization and provide the best tools for enabling the business to achieve its goals, but we’ve achieved the right balance with Microsoft.”
Allergan is making great strides using the Microsoft Secure Productive Enterprise as an effective way to consolidate its position at the forefront of business innovation in the pharma industry.

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Examples of how nurses can improve patient experience with eHealth solutions

Examples of how nurses can improve patient experience with eHealth solutions

By Molly McCarthy as written on enterprise.microsoft.com
In my last blog, I wrote about what patient experience really means. Ultimately, it’s about instilling in your patients—and their families—confidence and trust in their care.
Patient experience is something that nurses care deeply about. We all entered this profession to make a positive impact on people’s lives, as well as their health and wellness. And the good news is that today’s technologies are empowering nurses to do more to achieve that mission and enhance the experience of patients and their families.
One example comes from the Cardiac High Acuity Monitoring Program (CHAMP) at Children’s Mercy hospital where they’re improving the outcomes of babies with hypoplastic left heart syndrome (HLHS) by engaging parents with a home monitoring app.
As nurse Lori Erickson writes in her blog, CHAMP is not a club any parent ever wants to be part of. She and her team acknowledge that from the beginning and work to at least make parents’ experience with home monitoring good as they go through the high-risk period between their baby’s first and second surgeries.
To learn how they’re doing that, read Lori’s first blog. And for tips on how to successfully engage people in home monitoring so that you can partner with them to improve their health and quality of life, read her second blog.
Another example comes from OneView Healthcare. It offers solutions for patient engagement and clinical workflow that are helping health organizations like the University of California San Francisco Medical Center at Mission Bay revolutionize the patient experience. To learn how OneView Healthcare was inspired by the founder’s own knee surgery experience, read the story. And to see a video of how OneView Healthcare solutions work, visit its website.
As Elena Casas wrote in her recent blog, when patients can be more engaged in managing their health and care journey, it not only enhances their wellbeing, it also makes their experience with the health system better. She shares examples of how cloud solutions can help nurses engage their patients with the same types of technology people use to manage other areas of their daily lives. Elena also explains how dispersed care teams can connect with each other and see an integrated view of patient information with these solutions, so they can provide people with more cohesive, patient-centered care. Read her blog to learn about the many ways you can take advantage of the cloud to improve the experience of your patients and their families.

How infrastructure will help cure healthcare

Healthcare infrastructure will help cure healthcare

By Emmi Kendall as written on techcrunch.com
Donald Trump’s election has left many wary of how he’ll respond to a campaign promise to dismantle Obamacare. It seems that select aspects of the Affordable Care Act (ACA), aka Obamacare, will remain intact. Likely to remain are provisions that make it illegal for insurers to deny a patient’s pre-existing medical conditions and enable children to stay on their parents’ insurance plans through age 26.
While not part of the ACA, structural innovations designed to control cost, such as the shift to value-based care (VBC), a new way of paying doctors and hospitals, will likely continue (more on this later). The Center for Medicare & Medicaid Services (CMS) may cancel their timeline for this shift, slowing momentum. However, private insurance plans and doctors have already changed the way they contract together, making very unlikely a retreat to the old payment model.
Even without a crystal ball of the exact specs of a post-Trump healthcare world, the fundamentals of the healthcare market and the massive forces acting upon it continue to render it an excellent investment opportunity. Specifically, the most near-term and pervasive value-creation area is in infrastructure software, the “glue” that serves as middleware for healthcare.
The persistent truths are that the healthcare market represents $3 trillion, almost 20 percent, of the U.S. economy. This market also is plagued by a level of gross inefficiency and under-performance largely unseen in any other industries in our post-internet world.
Why has healthcare lagged behind so much?
Largely, it’s because despite complaints about skyrocketing costs, there was no needto change. The lack of technology progress wasn’t because of a lack of available solutions, but rather because of a lack of economic incentive. Incumbents maximized profit by continuing along proprietary business processes and technology paths, because doctors and hospitals got paid by insurance companies for every single transaction of care. Nobody stood to gain by re-engineering for common workflows or common infrastructure. Siloed operations were sufficient under a payment model based on transaction volume.
The paradigm, however, is shifting dramatically.

Consumers and new payment rules are inverting healthcare

The new role of “patient as consumer” is key in making healthcare behave like a more normal market. High-deductible health plans are the driving engine. In 2006, only 6.2 million members in the U.S. were on high-deductible plans. By 2015, this number grew to 58 million, a growth rate of 28 percent per year. Because almost 90 percent don’t exceed $2,000 per year in healthcare spending, 50 million people are effectively paying 100 percent of their healthcare out-of-pocket!
Unsurprisingly, this will start to change consumer behavior. Previously, patients had a significantly higher threshold for bad experiences because they largely weren’t paying. Increasingly, payments are made by patients themselves and/or insurance companies based on outcome and experience. Healthcare providers that had optimized only around transaction volume are finding themselves in sore need of new CRM-like tools for a consumer-centric business: to segment/acquire/retain the right patients, control costs, message/coordinate care effectively and streamline processes.

There is an emerging crop of healthtech entrepreneurs who see the more stage-appropriate opportunity actually lies within the infrastructural layers.

The second catalyst for change is CMS. This department spends almost $1.1 trillion on healthcare each year, making it the largest payer in the country. They’re also changing how they pay. With the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), Medicare has said it will pay for healthcare in a value-based way. Value-based payments invert the traditional healthcare business model: Instead of paying for healthcare transactions, doctors and institutions are to be paid for healthcare outcomes. Previously, the volume maximization recipe was “more patients, more revenues.” Now, the goal is to try to keep patients from needing the healthcare system at all.
The impact is amplified as private insurance companies are quickly following suit. Importantly, because these changes are being driven by Medicare, they are not impacted by the potential repeal of the ACA. As noted above, the repeal of the ACA may temporarily slow incorporation of new programs, but the industry transition to value-based care will continue. Under this model, standardization and integration are imperative, because value-based payments cover an entire “episode of care” (typically 90 days). Now needed are technical capabilities that enable longitudinally tracking of patients’ care histories and outcomes, auditing activity-based cost of services provided and determining return on investment for each episode of care.

Infrastructure as the missing glue

The new world order has spurred a deluge of healthtech applications. Startup Health notes that the first half of 2016 was the strongest ever start to the year, with $3.9 billion of venture capital invested. However, most entrepreneurs reflexively focus on the seemingly lower-hanging fruit of consumer apps (lose weight, track steps, send photos straight to your dermatologist) or enterprise point-solutions, such as appointment scheduling, patient intake, patient risk stratification, etc. All legitimate problem areas.
However, without any horizontal infrastructure, each of these solutions takes forever to develop and subsequently function only in specific walled-data silos. So, following an unduly protracted dev cycle, a product further leads to duplication of work every time it extends outside the original data pool — which happens a lot. Instead of these abundant headline-grabbing consumer apps or siloed enterprise point-solutions, the best investment opportunities actually are found elsewhere: in infrastructural software providing best-in-class functional solutions pervasively needed across the broader universe of healthtech apps.
What do the best healthtech investments look like? Best-in-class infrastructure. What exactly does this mean? It means horizontal infrastructure that allows application-layer CTOs to outsource discrete functionalities and compress their own dev cycles.
It’s taking a page from the playbook of current-day pure-play tech CTOs who now can choose from a plethora of application program interfaces (APIs), software development kits (SDKs), platform-as-a-service (PaaS) and infrastructure-as-a-service (IaaS) partners. This enables them to focus solely upon their core product and outsource much of their tech stack (e.g. AWS for hosting, Twilio for messaging, Mixpanel for analytics, Salesforce for CRM). This is in stark contrast to the dev protocol in the late 1990s, when startups were capital-intensive and vertically integrated because they lacked a robust infrastructural ecosystem of developer tools and third-party cloud solutions.
Today, the pure-play tech app CTO has evolved to “borrow instead of build whenever possible,” in the words of Instagram co-founder Mike Krieger, in order to “focus on actually building out your product.” In healthtech, however, we still see too many app developers try to build everything natively, thus delaying focus on their core product. Invariably they burn through much of their early-stage financing runway before working on their core product enough to secure the proof points necessary for follow-on investment rounds.

MJHS celebrates nearly 110 years of care and innovation with modern Office 365 workplace

mjhs-managed-solutionMJHS celebrates nearly 110 years of care and innovation with modern Office 365 workplace

By Stuart Geller as written on blogs.office.com
Since “The Four Brooklyn Ladies” founded the MJHS Health System (MJHS) in 1907, we have grown into one of the largest not-for-profit health systems in greater New York. One of my challenges is to ensure that the values of a nearly 110-year-old healthcare provider are reflected in the 21st-century technology we use. With Microsoft Office 365 cloud-based business tools, our employees work productively in today’s digital world, while preserving the innovative, culturally sensitive healthcare services that are part of our history.
Before we settled on Exchange in the cloud, we used another product as our on-premises messaging and collaboration platform. This system had significant email reliability issues and storage limitations. We needed cloud-based business productivity tools that aligned themselves with the highly-regulated healthcare industry, where we are required to meet HIPAA standards. We evaluated G Suite (formerly Google Apps for Work) but chose Office 365. First, Microsoft signed a Business Associate Agreement, something that Google was unwilling to do at the time. And we were more than satisfied that Office 365 met our strict standards around security and compliance, in everything from email retention to archiving and eDiscovery. We also use Office 365 Advanced Threat Protection that bolsters our defense against malware and phishing emails. It’s great to see Microsoft offerings evolve to keep pace with swift changes in the threat landscape.
At the enterprise level, it’s important to use technology that works in the language of the industry. Our employees are familiar with Microsoft offerings, and the ease of transition to the new business tools was a great incentive for us. Not only does Office 365 ensure that we will always be on the latest version, but the interoperability of the different components of the suite is efficient and effortless, improving productivity.
We pride ourselves on delivering innovative, sensitive patient care in the home. Our mobile health workers carry Windows-based devices and now they can use Office 365 to access the information they need to do their work, without returning to the office. With Office 365, mobile access to all our technology resources is easier than ever, which means more time interacting face-to-face with our clients.
We are seeing increased interest in video conferencing across MJHS with Skype for Business Online, especially for board meetings and presentations. We are piloting the PSTN conferencing capabilities, and we are excited to make the most of the newest functionality, particularly Dynamic Conference Codes, which eliminates overlapping conference calls and protects the privacy of each meeting. By eliminating existing superfluous conferencing solutions, we expect to reduce our costs in this area by 80 percent.
And by consolidating other third-party providers, for mobile device connectivity, archiving and eDiscovery capabilities, we have further simplified our administration and significantly reduced our overall costs. With Office 365, these types of services come standard, and once again allow us to acquire great functionality with a reduction in costs.
The Four Brooklyn Ladies could never have imagined how much healthcare would change in the past century. However, it’s great to know that with IT tools like Office 365 we can ensure that their core values of cultural sensitivity, service and compassion are still at the forefront of our service to the community.