Anticlue

HIMSS 2004 Happenings

HIMSS 2004 occurred last week, and unfortunately some of us were not lucky enough to go.

So, Health Data Management has some highlights found here.

Useful Management Information

When developing a report for management, there are certain characteristics that the report must contain in order to be useful.

First, the report should be information, not just raw data. A report of over 500 pages of records to be looked at individually, is just a lot of data. But taking that data, grouping, categorizing, and doings simple stats on provides better information for the intended audience.

Second, the information should be relevant to the purpose it is to be used for. Don't report that in 2001 we had 3 instances of this item, when that is not timely or pertinant to the task at hand.

Third, the information should be sensitive enough to allow for comparisons for the audience. Basically don't overly summarize the information into one lump sum. Have various categories.

Fourth, the information should be unbiased. Allow the information to be objective so the audience can decipher and form their own conclusions. Don't have the information presented in a format that leads to biased conclusions.

Fifth, information should be timely. It should be there before the audience realizes they need it to make a decision. Have the needed information accurately timed with the operational need.

Sixth, information should be action-oriented. The information should be presented in a format to reach the end goal of the projects or business process. It should not be based on passive indicators of items one can do nothing about.

Seventh, information should be displayed in a uniform structure. All reports should have a standardized structure. This way the audiences has an idea of where to look for certain information. For instance, have one report to one page, not one page having two reports that linearly look like the same thing.

Eighth, information should be performance-targeted. It should be designed and presented in accordance with predetermined business goals and objectives.

Last, information should be cost-effective. The benefits from having the information should outweigh the cost of collecting and processing that same information.

Stages of Internet Business Maturity

Sometimes there are huge gaps in expectations of where you should be with in the user communty and where you actually are in the stage of business maturity.

First Consulting Group has outlined the Stages of Internet Business Maturity.

<--- Snipped from First Report --->

These stages provide a clear and concise way to strategically move from the publish, interacting stages to actually being able to transact, integrate, and transform the business main systems to a web environment. The main idea is that you need to know when to jump, and where you want to land. Also to establish a set of guidelines to appraise new endeavors. The guidelines recommended in the article are the five rights.

<--- Snipped from First Report --->

• Right Process: Not all processes need to be accessible via the Web. High- volume transactions that require minimal health plan analyst intervention are most successful. The prioritization of processes is key to maximizing the benefits for both the end-user and the plan.
  Examples of high-value processes to tackle include membership registration,
  PCP selection, claims tracking, and claims submission.


• Right Customers: For the selected process, design must address several “rights” about the customer such as what role they play in the business environment on their end, the communication modes that are feasible (are all physician office billing specialists online?), and how the function can be shaped to fit into the customer’s routine workflow. Truly understanding the customer to be sure that if we build it, they will come!


• Right Time: Not all transactions need to be completed in real time. Some functions such as requests for information can be emailed back to the end-user. Others require real-time responses reflecting all of the business logic in the legacy application, with immediate updates to the database.


• Right Technology: Matching the timing, selected processes and end-user needs will affect the technology choices for development and integration tools. Technology component choices for the project also need to be examined in the context of the entire integration plan to avoid duplication and/or replacement as the organization moves further towards the desired level of Web to legacy integration. For example, buying advanced Enterprise Application Integration (EAI) functionality for one project can make sense if it is used to support more complex technology requirements for another project. This type of planning becomes key, for example, as organizations are moving towards HIPAA compliance, where the initial EAI investment may focus only on transaction compliance. However, the same EAI infrastructure can be leveraged for other Web-based business transactions outside the scope of the HIPAA regulations.


• Right Outcome: Setting objectives and understanding the actual impact of the solution on process and people is a critical step to attaining real value. Realistic expectations should be identified and agreed upon with all of the involved business units. Once the solution is online, the outcomes should be measured and compared with expectations. Adjustments to process and/or technology are often needed to attain desired benefits. Conversely, unexpected benefits may be uncovered in post-implementation monitoring. An added plus that is worth knowing!

About posting lately

Been a little busy with life lately and haven't had the opportunity for early morning postings. However, the good news is that I think that situation has rectified itself lately.

Mach 1.0.9

According to http://www.corfield.org/blog/past/2004_02.html#000305, an updated Mach II version was released yesterday in accordance with the development guide.

How do you manage a project?

TechRepublic has an article on the top ten project management skills.

<--- Snipped from TechRepublic --->
1. Define the project
2. Plan the work
3. Manage the workplan
4. Manage issues
5. Manage scope
6. Manage risks
7. Manage communication
8. Manage documentation
9. Manage quality
10. Manage metrics

Looking at the list, I began to wonder how do other places manage a project? Do you have a central office responsible for managing all projects? Or is there a project coordinator? Does IT do most of the project management or do the business users?

How does your organization handle project management? or does it even see the concept as existing?

Usable Forms

Site point has released a couple of trick for more usable forms with JavaScript. The article is found here, and a demo is found here.

Open Source Extensions, Components, and Function

Matt Liotta has recently opened http://sourceforge.net/projects/openxcf

The Open Source Extension, Component, and Function (OpenXCF) project hosts open source ColdFusion Markup Language (CFML) code in the form of ColdFusion Extensions (CFXs), ColdFusion Components (CFCs), and User Defined Functions (UDFs).

His goal is that this site will create a community around open source code and enhance the code, instead of letting the code become forgotten.

Customer Survey's

Jakob Nielsen release another alert box article today, on keeping survey's short. He relates that the simplest solution to maintaing a smaller sized survey is to ask direct questions that get at your ultimate goal.

For instance, if you are concerned about customer satisfaction. What is the highest measure of satifiscation? That is having a customer recommend your services or site to someone else.

How likely is it that you could recommend [X] to a friend or colleague?

Allow the user to choose either very likely 10 between unlikely. For instance this survey's question 3.

If the customer answers a very likely score, the they are a promoter, low scores 5-0 are detractors. Take the number of promoters minus the number of detractors, and there you have the net promoter. (Basically more people are satisfied and willing to recommend your service rather than those who are in the other boat)

Smaller surveys enhance usability and give clearer results. One just has to think with the ultimate end in mind.

More Trouble than They're Worth

In this month''s Harvard Business Review, there is a list of Breakthrough Ideas for 2004. One listed is the "No Assholes" rule in hiring. Basically it describes "stars" that get away with abusing people. Some organizations tolerate it, other's simply implement the rule.

There are two tests listed to determine if you are dealing with a difficult person.

First, after someone talks to the alleged, do they consistently feel oppressed and belittled by the person, and, especially do they feel dramatically worse about themselves?

Second, does the alleged consistently direct his or her venom at people seens as powerless and rarely, if ever, at people who are powerful?

I think this is a great measure of the character of a person, and a good hiring rule.

Realistically the team as a whole is the most important factor at work, and having one bright star that wreaks the team, isn't really that great of a way to go.

Add or Remove Debugging IP

Qasim Rasheed has added addRemoveDebuggingIPAddress(ipAddress [, action]) to CFLib.

Pretty useful feature.

CF Technote on ODBC Services

Macromedia has released a Technote on manually installing and uninstalling the ColdFusion MX ODBC services. This is to be used when the wizard hangs on installing ODBC Services as described in the technote here.

Quality of Care

From the Business Word this morning, Patient's don't use the data in picking providers, there is a commentary of the wsj's the informed patient by Laura Landro editorial, It's Time to Care about Ratings Data.

The editorial mentions a health-care conference that had speakers calling for investments in information technology. One example given was an EMR, to help better monitor patient care and analyze the effectiveness of the care. Eventually even to disclose that information to health-care consumers.

<-- Snipped fro wsj --->
One big barrier is that health-quality ratings don't provide much detail or information on crucial quality measures such as complication rates and medical errors, which have long been widely protected from disclosure to the public. But that could be changing. Although it will be some time before any detailed data are widely available, the new Medicare law includes a voluntary hospital quality-reporting system that will provide information to the public on 10 measures of care for three conditions -- heart attack, the chronic condition known as heart failure and pneumonia. Both Medicare and private business groups are testing payment and reimbursement methods tied to such quality measures.

The Agency for Healthcare Research & Quality has a new website www.qualitytools.ahrq.gov to help measure and improve the quality of Americans' health care.

Currently, imho, most patient decisions on the physician who cares for them is made either via word of mouth, or the outcome of an emergency situation. It would be nice if there was a better evaluation mechanism, than the same mechanism one uses to choose a restaurant.

With my previous posts yesterday, on the increase of people using the web to find health information, maybe this is an idea whose time has come.

Sharing the Sponsorship of EMR

Georgia docs, Blues study business case for EMR by Modern Physician covers a plan to create a business case for an ambulatory Electronic Medical Record (EMR).

The interesting point is that funding is coming from both the payer and the physicians. This technique of a joint venture from the payers and physicians expands the stakeholders to more than just the physician. An EMR needs to be sponsored by all of the healthcare stakeholders, not just the burden of physicians.

Analytical Hierarchy Process

Sometimes there are evaluations that need to be placed through a rational process instead of a subjective mechanism. A rational evaluation process eliminates emotion from the choices. This process can be utilized in evaluating multiple items such as vendors, developmental frameworks, and business process best practices.

The Analytical Hierarchy Process helps to solve multi-criteria problems by breaking down the criteria and comparing them to each other. An overall wieght of the criteria is compared through out to help arrive at the best decision.

This is an example for a CMS System evaluation with different vendors.

AnalyticHierarchyProcess.doc
AHPCalculations.xls

Yukon T-SQL Enhancements

Yukon looks to have several new features. You can find the full article here. Among the new features are:

• Try/Catch construct for error handling


• SnapShot Isolation level


• WaitFor Command


• Common Table Expressions


• The PIVOT operator

Who is using the net

If you are looking for overall statistics on the Internet and who is using what. A very good report was published by Pew Internet & American Life project called America's Online Pursuits.

<--- Snipped from the America's Online Pursuits report --->

• As Americans developed expectations about finding vital information on the Internet, those seeking health information online grew by 59%. There were about 46 million Americans who had looked for health or medical information online as of March 2000, and the figure grew to 73 million who had done so by December 2002. In fact, the figure is closer to 93 million, if a variety of health-related searches are asked of Internet users.

Also another good report is on the Internet Use by Region in the United States.

<--- Snipped from the Internet Use by Region report --->

• The regions of the country with the highest rates of Internet penetration are along the Atlantic seaboard (New England with 66% of the adult population using the Internet and the Capital region with 64% using the Internet) as well as the Pacific seaboard (the Pacific Northwest with 68% online and California with 65% Internet penetration.

And finally if you are looking for what individuals are looking for as in Health Information on the web, take a look at Internet Health Resources. Very interesting indeed.

Phonetic Site Squatting?

Don’t know if you have seen or heard of this, but from the wsj (paid subscription required) Mike Rowe setup www.mikerowesoft.com. Microsoft took action on name infringement, and the outcome is Mike will be reimbursed for moving his site, get to go to a tech conference, and get help with obtaining Microsoft certification. Microsoft gets to keep the name Microsoft and the phonetic alteration of it.

Focusing on your audience

This isn't really a hospital website, but I think it is a great example of providing direction tuned to one's audience.

Take a look at Kaiser Permanente's homepage, what a great way to profile and customize to an audience. Its also clear and user friendly.

Email Consultations

Its been about a month, since the AMA introduced coding for email consultations between physicians and patients. Currently a couple of plans, such as the blues, cover online visits.

However, I think email consultations will help to advance a level of convenience in care to patients. For instance, for controlled substances, (ridilin), perhaps it would be easier to have a new prescription requested via email versus a visit with the physician. While it is always good to see your physician, a 30 second email frees the patients and physicians time, when comparing it to an office visit.