Christina's Considerations

Biomedical Device Integration

I've been thinking about the need to integrate biomedical devices into an electronic health record (EHR) to eliminate the need for manual entries and came across an article.  In addition to integrating data collected by the devices in a healthcare setting, I'd also like to see home monitoring devices integrate into a patient's personal health record (PHR).

PSQH covered the biomedical device integration and the importance of addressing the workflow and the positive link of the patient to the technology.  My hope is that the technology will advance and the workflow issues will be resolved so that a patient in the ICU on a smart bed can be set to automatically weigh a patient at designated intervals and record the data automatically in the patient's chart.  Alerts and alarms would need to be in place in the EHR and on the bed if the weight fell below or exceeded acceptable ranges.

Wow!  What a concept!

Social Media in Healthcare: Connect Communicate Collaborate

I haven't been posting because the NRTRC and final edits to my new book are keeping me really busy.  I just received the pre-production flyer and am really happy to see the light at the end of the tunnel.  Please check it out, especially if you would like to see if you are eligible for a discount! 

Additional information can also be found in the Executive Essentials section of the HAP website!

P.S. For those of you needing Category 1 Credits, stay tuned for the self-study course that this based on the book.

State 1 Criteria for Meaningful Use

Health Data Management Magazine has a chart that lays out stage 1 criteria for meaningful use.  I think it is worth holding on to for reference, thus it is here on my blog.

The final rule is available at http://edocket.access.gpo.gov/2010/pdf/2010-17207.pdf

New legal impact of a loss of generator power due to flooding

If you have a generator in your hospital basement or your facility is located in any part of a flood zone, you need to be concerned about some recent legal activity.  It involved the old Methodist Hospital in New Orleans that lost power when its basement flooded after the breaks in the levees during Hurricane Katrina.  The power failure may have, in part, lead to death of a newly ventilated patient.

The Louisiana Supreme Court decided that the family could seek damages under general liability rather than limiting the suit to medical malpractice, which is capped at $500,000 in the State.  It seems there may now be a settlement, but there is a warning here for hospitals. 

To me, it comes down to the question, is your generator located in an area with the potential for failure in a flood, or other, scenario.  If so, you risk of exposure to general liability suits if during a disaster your generator fails - for any reason.  I fear this is moving us toward fail-proof disaster preparedness and wonder who will pay the cost to move all of the generators located in areas at risk for flooding.  And, for a big hospital, are they light enough to be placed on the roof.  The last new one I saw was a monster and I would fear it being on the roof, especially in places like California and other earthquake zones.

I'm torn.  We strive to be prepared, and often times do our best while juggling multiple jobs (COO, Risk Manager, & Safety Officer).  Now, we may have to be PERFECT and where will we get the money.  The designs of new hospitals can take into consideration our lessons learned.  But, older hospitals will need to balance this risk with all of their other capital needs.

So, if there is any risk for flooding due to significant rainfall, a water main break, levee break, overflowing rivers or streams, or a tsunami then be prepared to have general liability claims filed in addition to medical malpractice.  I'm afraid the bar is being raised.

I wonder what would have happened if they simply ran out of fuel.  Would we instead be talking of the expectation that hospitals have even larger underground/above-ground storage of fuel in case of an event like Katrina. (I wouldn't want to live or work in that neighborhood)  Lets draw a reasonable line; please!

Superbowl Commercial: What employees really DON'T want!

To Lead, Create a Shared Vision

I really enjoy Harvard Business Review's topics and their approach to management and leadership. (Did you know both are very different?) One of their papers (only one page) is a good read for any leader during this challenging economy and time.  It reminds us of what employees are looking for in their leader and how to formulate a vision.

My favorite part of To Lead, Create a Shared Vision is the example near the end.

"One of his direct reports said to him, "You would benefit by helping us, as a team, to understand how you got to your vision.  We want to walk with you while you create the goals and vision so we all get to the end vision together."

Ian's Messy Desk has another view is this issue -- how not to be a leader.

Northwest Regional Telemedicine Resource Center

Yesterday, I began a new adventure as the Executive Director of the Northwest Regional Telehealth Resource Center.  The NRTRC leverages the collective expertise of 33 telehealth networks to share information and resources and develop new telehealth programs across:

• Alaska
• Hawaii
• Idaho
• Montana
• Oregon
• Utah
• Washington
• Wyoming
• US-Affiliated Pacific Islands

The NRTRC views the technology as an enabler and is guiding the development of telemedicine solutions in the region to enhance health care delivery systems, while reducing organizational and patient costs. NRTRC is one of six Telemedicine Resource Centers collaborating and leveraging resources to provide unbiased services and support.  If you would like to learn more about the resources offered, visit one of the links below.

Great Plains Telemedicine Resource and Assistance Center (Great Plains TRAC)

Northeast Telemedicine Resource Center  (NETRC)

Center for Telehealth and eHealth Law (CTeL)

California eHealth and Telemedicine Center (CTEC)

Midwest Alliance for Telehealth and Technology (MATTeR)

Northwest Regional Telemedicine Resource Center (NRTRC)

If you live or work in one of the states listed above (in the NRTRC region) and have an interest in telemedicine, please visit the site and contact us with any questions.