Tag Archives: eHealth

Procurement Meets Moore’s Law

The following is an article that recently appeared in Healthcare Information Management & Communications Canada magazine:

My father, the consummate bargain hunter, has never heard of Moore’s Law.  Yet, on a regular basis, he takes advantage of the falling prices that are one its inevitable consequences.  My father has learned that he need only wait a couple of years after a new technology is announced for the price of products based on that technology to drop to the level he is willing to pay.   Paradoxically, the same rapid changes in technology that benefits consumers like my father may, in the context of long government procurement cycle, stifle innovation and lead to failed health IT projects.

In a 1965 paper, Intel co-founder Gordon Moore noted that “the complexity for minimum component costs has increased at a rate of roughly a factor of two per year” and predicted that this “rate can be expected to continue”.  This prediction became known several years later as Moore’s Law and has been the source constant innovation in the IT sector for more than half a century.

The impact of long procurement cycles on IT related procurement has been evident in the defence and aerospace industries from quite some time.  A 2006 book on C4ISR (Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance) for future naval strike groups prepared by the U.S. Naval Studies Board concludes:

“The current procurement process of the Department of Defense concentrates on buying ships, airplanes, tanks, and so on. Most of these items have lives that are measured in decades, with few major upgrades over their lifetime. Information technology is changing on the time line articulated in Moore’s law and does not fit into such a process.”

Closer to home, an article in Vanguard, a Canadian defence and security magazine notes:

“Today, the emphasis in federal government procurement is on inputs, with detailed specifications of what, in IT, are constantly moving targets.”

This same article quotes Kamel Shaath, chief technology officer of Kanata-based KOM Networks.  Mr. Shaath contends that “procurement even is inhibiting innovation at times because they [government agencies] are not able to take advantage of new technology.”  Mr. Shaath recommends:

“We need to foster innovation and to have procurement processes that allow the government agencies to embrace and adopt new technologies on a much more rapid pace.”

At the 2012 eHealth conference that took place in Vancouver earlier this year, the opening key note speaker, Dr. John Halamka, was openly critical of the processes used to procure health IT systems and claimed that these practices stifle innovation.    In a blog post written soon after the eHealth conference, Dr. Halamka asserts that “Traditional procurement approaches are likely to acquire technology at the end of its lifecycle.”

While procurement reform is certainly a hot topic, it will, by its very nature, take time to happen.  In the meantime, we might want to consider the advice of Chris Gunderson, a Research Associate Professor of Information Science at the U.S. Naval Post Graduate School and a retired U.S. Navy Captain.  Driven by what he call his “frustration at us Good Guys’ inability to get out of our own way when it comes to acquiring and applying to technology”,  Professor Gunderson is devoting the latter part of his career to “co-opt the government bureaucracy to consume my lessons learned about successful distributive, collaborative e-Biz ‘best practices’ in-spite of itself.

In an October 2009 interview with Ubiquity magazine (an Association of Computing Machinery publication) Chris Gunderson makes a similar case regarding the challenges of IT procurement in the face of rapid technological advances as others quoted in this article:

“The downside of all these restrictions is that the time for the government to procure and deliver a major system is easily a decade or more. With the environment of use changing at the rate of Moore’s Law, the delivered systems are almost always obsolete or obsolescent.”

While acknowledging these challenges, he offers hope that they can be overcome:

“I’ve learned that the best way to achieve powerfully disruptive change is by subtly co-opting the existing processes. By “co-opt” I don’t mean anything subversive or underhanded. I simply mean we should introduce more convenient and efficient methods within the constraints of the existing bureaucratic requirements. The improvements will be adopted because they are perceived as both comfortable and useful.”

Mike

Long Live the Narrative Note

Computers that understood the spoken word was a popular theme in science fiction books, movies and TV shows when I was growing up. Consider, for example, HAL 9000 from 2001: A Space Odyssey (“I’m sorry, Dave. I’m afraid I can’t do that,”) or the computer on board the Star Ship Enterprise from the Star Trek series (“Computer, Tea, Earl Grey, Hot.”) Ever since my youthful fling with science fiction, I have long been intrigued by the possibilities of computer software that understands the meaning of what a person says. Imagine, I have often mused, if we could apply this technology to the narrative notes that are viewed by many people to be an anachronism impeding efforts to share and analyze patient health information.

Check out the rest of this article at 
http://www.canhealth.com/tfdnews0544.html

Mike

 

COACH Board of Director Elections – Vote Today!

COACH is the Canadian association for health informatics professionals.   I am a member and have been  since I first got involved in the Canadian health IT sector.  I volunteer my time on several COACH initiatives and take every opportunity to support the organization.  

Today, I’d like to remind fellow COACH members that voting in now open for the COACH board directors.  22 candidates have been nominated for 5 open positions. There are many excellent candidates, many of who I know personally.   To help them promote their candidacy, I am offering all board of director nominees the opportunity to post their platforms as a guest post on this blog.    Simply reply with your platform as a comment to this post and I will create a new post that contains your platform.

If you are not a COACH member than I suggest you check out the many benefits at http://www.coachorg.com.  

Mike

 

Interest in the COACH Board of Directors is keen with 22 members stepping forward as candidates for the five vacancies for 2012 – 2014. Be sure to “meet” them and learn about their experience and reasons for wanting to join the Board on the Candidate Profile pages along with the Candidate Nomination Summary.

Due to the number of candidates, the summary is provided in lieu of an All Candidates Webinar.   

Online voting will open April 16 and be available to COACH members through April 27. Voting instructions will be emailed to COACH members.

mHealth Rant

Check out my latest article in Technology for Doctors, an online publication for which I write a monthly column.  You can find it here.

I’d like to hear views on whether we need yet another buzzword.  I argue that mHealth will cause more confusion among potential users and divide the health IT community at a time when it should be united.

Mike

 

 

 

2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 25,000 times in 2011. If it were a concert at Sydney Opera House, it would take about 9 sold-out performances for that many people to see it.

Click here to see the complete report.

Calling Ottawa health IT professionals, healthcare professionals, and IT vendors

As some of you may now, I chair the program committee for the OCRI IT in Healthcare speaker series.   Each month we  host informative speakers who share their insights and experience on topics of interest to healthcare providers, health IT professionals, and IT vendors.

On October 5th, we are teaming with COACH, the voice of Canada’s health IT professionals, to host a special one-day conference that brings the local health and IT communities to explore ways that these two communities can work together to develop innovative health IT solutions.   This unique event will focus on practical and affordable applications of health IT that address today’s healthcare challenges and offer near-term benefits.

Whether you have an idea for a new application that you think will benefit the local health sector or  want to share your challenges with people who can offer a fresh perspective, please join us on October 5th.     I look forward to seeing you there.

You can find more details here.

Mike

comunityies

OCRI, the voice of the Ottawa R&D community and COACH, Canada’s health informatics professions, have joined forces to host a special one-day event

“Shutting down eHealth would be just dumb!” – Minister Deb Matthews

Earlier this week the Ontario Liberal Party hosted an on-line text chat with the Minister of Health and Long Term Care, the Honourable Deb Matthews.  The session was moderated, with the audience posing questions to a facilitator who selected the questions for the minister to answer.

I posed a number of questions related to the use of health IT, the future of eHealth Ontario, and the Minister’s thoughts on LHINs.  Of the various questions that I posed, the moderator selected my question about eHealth Ontario.  I asked the Minister about whether eHealth Ontario would continue to exist under a Liberal government.  Minister Matthews replied:

“Anyone who works in health care knows that we need to continue to transform it unless we want to move to two-tier health care, which Ontario Libs certainly don’t!! A vital part of that transformation is moving forward with eHealth. We’ve now got about half of Ontarians with EHRs – shutting down eHealth would be just dumb!”

As the minister did not directly refer to eHealth Ontario, it is not clear whether she was stating a commitment to the agency or to continued investment in eHealth.  Perhaps “eHealth” was intended as short form of “eHealth Ontario” or maybe she was being purposely vague.  Whatever the case, I am pleased to see the Minister recognize the role that health IT can play in transforming our healthcare system.

Mike

 

 

Steven Huesing Virtual Debates – First Debate

About a month ago I wrote a blog post about the The Steven Huesing Debates on Digitizing Canada’s Healthcare System. This virtual debate series is intended provide a platform to engage all stakeholders in open, unfettered discussions about the about the major issues impacting eHealth adoption and use, such as:

  • Measuring the return on value to the patient
  • Improving quality and safety
  • Data sharing to respect the privacy rights of patients
  • The appropriateness of the current agenda

The debates will be conducted virtually and will include a public commenting period. The first debate took place on 12 April 2011 and the public commenting period is now open. You can find information about the debate series as well as a recording and written synopsis of the first debate here.

I urge readers of this blog to participate in the virtual debate. Please check out the virtual debate website and offer your thoughts and comments. In particular, please offer your thoughts on the topics to be discussed In future debate sessions. The currently identified topics include:

  • Patients as co-creators/owners: Should the HIT agenda change to build the infrastructure that ensures personal health information rests with the patient who shares it with others? Do you want patients to genuinely become a co-creators—to share power
  • Aligning business models to incent using these systems: What changes in the current approach (business model and incentives) are necessary to speed up adoption and change processes of care to drive out more value?
  • The need for e-health policy: The technology roll-out is advancing before we have e-health policies in place. What policies are needed to address challenges or potential barriers?
  • Regulation vs. government edict: What would be the best approach to creating a carrot and/or stick regime to speed up adoption by clinicians?
  • The right balance between top-down and bottom-up to drive the agenda: Is HIT in Canada emphasizing a more grassroots agenda driven by the patient and providers rather than a top-down approache driven by governments?
  • Do we need a higher sense of urgency with the HIT agenda? If the answer is yes, then what do we do to build this into decision making and implementation?

What are your thoughts on these proposed topics? Are there additional topics that should be considered? Please go here to participate. Also, please let people in your own networks know about the debate series and encourage them to participate

Mike

The Steven Huesing Debates on Digitizing Canada’s Healthcare Systems

Late last year a small group of people decided that a mechanism was needed to engage more people in active discussion regarding the digitization of Canada’s healthcare system. Until now, very little real debate about the current healthcare IT agenda has occurred. Discussions to date have tended to focus on system manager needs and not so much on health outcomes. Most key stakeholders have had little say — providers, vendors, researchers and, most importantly, patients.

The Steven Huesing Debates on Digitizing Canada’s Healthcare System provide a platform to engage all stakeholders in open, unfettered discussions about the main unresolved issues, such as:

  • Measuring the return on value to the patient
  • Improving quality and safety
  • Data sharing to respect the privacy rights of patients
  • The appropriateness of the current agenda

The debates will be conducted virtually and will include a public commenting period.  The first debate will take place at noon eastern time on 12 April 2011 and will focus.  The debates and the commenting period that follows are open to anyone who wishes to add a comment. There is no cost for participation.  You can find more details here.  I encourage you to participate in what I hope will be a lively and informative debate series.

Mike

 

mHealth Rant

OK, I’ve heard the “mHealth” term one too many times and I feel compelled to shout “enough already”. While I think that the ability to put information into the hands of healthcare providers and patients wherever they might be has the potential to transform healthcare, I do NOT believe that applying mobile technologies to the delivery of healthcare services warrants a new word to describe it nor that we should treat it as something fundamentally different from other eHealth technologies. When you strip away the hype, a smartphone is just a computer with a small screen and very long network cable. You still need the same servers and databases as you do for a desktop computer, or a laptop with a wi-fi card, or a netbook with a 3G stick.

Let be crystal clear … I think that making information accessible to people on the move will be transformative. I just don’t think that it is a distinct technology or that we need yet another buzzword. mHealth is NOT distinct from eHealth or Health IT (HIT) and we should banish it from our vocabulary.

Mike