Anticlue

EMR Adoption Model

RHIOs were largely discussed at HIMSS last week, and rightfully so, its good to flesh out and discuss a new model before implementing it. After all RHIOs will be first carried out by the bleeding edge revolutionaries. However, to truly get the full usage and practicalities of a RHIO, it is necessary to have an EMR in place. I think it is actually surprising to see how far we have to go in implementing such a solution. As I have said before in order to get where you are going, you need to understand where you are now. HIMSS analytics has recently published a white paper comparing EMRs vs EHRs. A subsection of the paper is the EMR Adoption Model, it lets you know where your facility is compared to others.

<--- Snipped from whitepaper -- >
The stages of the model are as follows:

Stage 7: The hospital has a paperless EMR environment. Clinical information can be readily shared via electronic transactions or exchange of electronic records with all entities within a regional health network (i.e., other hospitals, ambulatory clinics, subacute environments, employers, payers and patients). This stage allows the HCO to support the true electronic health record as envisioned in the ideal model.
The majority of US hospitals are in the early stages of EMR transformation. Currently 19 percent of US hospitals have not achieved Stage 1 and are at Stage 0, 21 percent have achieved Stage 1, 50 percent have achieved stage 2, approximately eight percent have achieved stage 3, approximately two percent percent have achieved Stage 4, and less than one percent of hospitals have achieved stage 5 and stage 6.

Top Java Books

Java Lobby released the top books in Java Programming, some I would say are the top books for any application programmer to read and understand. And as always there is always more to read.

Soarian Financials

Yesterday, I spent quite a bit of time with Dennis from Siemens Soarian Financials. We are going to the Soarian Suite of Applications, we have started with the Soarian Clinical Access which should be up and running in June, early July. However, my role has changed quite a bit in the last year, one of the changes was a switch in reporting from the clinical side of the house to the revenue cycle side of the IT house.

It was several years ago, that I got my first glimpse of Soarian Financials. The power point presentation didn't even have a prototype yet, needless to say the company has come along way.

As Dennis answered all of my questions, or astutely asked for further information into items like registration coding primary dx's according to chief complaints, or how mid-level providers billing was handled, how smart claims edits can be handled, and finally patient days and census reporting. One item that really struck me is that I'm not aware of any IT community, listserv or forums, that handles Soarian Financials, another item to follow up on later.

Soarian Financials appears to be a much smoother product than Invision, Signature, Invision Patient Accounting, and Eagle. Although the creation and engineering is continuing with features and functions, the road map is there.

I will say one item, I'm concerned over is the KLAS rating for both products was so low for the admission discharge portion. From HeathcareITnews, buyers guide on admission/discharge.

1. Quadramed Affinity Healthcare
2. GE Healthcare IDX Flowcast
3. Keane EX-Access Patcom
4. Meditech Registration, Community-Wide Scheduling, Billing/Accounts Receivable
5. McKesson Access Management Solutions
6. Eclipsys Sunrise Access Manager/Patient Financial Manger
7. Intranexus Saphhire
8. Siemens Invision Financials

And surprising not even meeting KLAS minimum confidence level

• Cerner Millennium ProFi
• Epic Resolute Inpatient
• Siemens Soarian

The other item I learned was that if you need to do reporting out of invision, signature, eagle, at any type of drill-down level, one needs to take a look at Siemens Datawarehousing. All of those Patient Census, and Patient Days reports are nicely in the system. Just an item, we choose not to purchase at an earlier time

Its time to drink the kool-aid

One of the activities on Monday, I attended was the Project Management SIG for HIMSS. I have come to the conclusion that it is time to start taking some action, instead of just lamenting on how misunderstood and underutilized this process has become.

When the opportunity arose, I joined the Executive Board. The obligation is minimal six 1hr meetings a year. What I am hoping to do is help layout the PM Sig Website into a repository for projects, applicable tools, and forums. A little community can go along way.

Electronic Bed Boards

As a part of yesteday’s Himss conference, I took full advantage of attending the session on realizing Quantitative and Qualiative Benefits using New Patient Flow Technology.

The session was obviously on implementing an electronic bed board, which I think after attending the session is a great idea. Nationally, patients are getting sicker and staying longer. Increasing patient float and decreasing available beds. Admission issues and available bed issues have already started.

Wonder if you have a patient flow problem, just look around. Are the admitting waiting and ED areas standing room only? Is there a long wait and an inability to admit patients? Is it hard to accommodate add-on surgery cases? Are patients ever placed in the wrong unit just because there is an available bed? Does the ED divert? How often does the ED divert?

So if you have answered yes, more than likely you are also suffering capacity issues. This is why a bed board is helpful. Length of stay is normally taken off of the midnight census, although there may be a 30 – 40 % variance during the day, the best way to determine where a patient has been through out the day, is to look at all of the transfers throughout the stay. Patient flow management defines and tracks any number of relevant transfers over time.

A couple of questions to ask during the implementation are:

• How many ways can we admit a patient, what are our entrances?
• How long does it take to transport a patient, how do particular segments work?
• How do we align the peaks with the staffing patterns?
• On average how many times does a patient move during a 1 day LOS, 2 day LOS, 3 day LOS?

Once you realize there is a capacity issue, there are a couple of ways to handle it

1. Shorten unnecessary patient time in rooms
2. Shorten vacant room time between patients, (what is the OR turnover time? Actually just have what is the {insert location} turn over time?)
3. Get more licensed beds, and expand size to accommodate the new beds.

The important item when examining capacity is to address the bottlenecks. Remember, patients only flow at the rate of the bottle necks. It doesn’t do any good to have all the non-bottlenecks occupied. Also once you work according to your constraint, bottleneck, another one will pop up, so be sure to look for it, and review the process again.

In implementing an Electronic Bed, lessons learned were:

• Patient Flow becomes better understood
• A manager of patient flow needs to be identified
• Housekeeping needs to know where to go next, so send housekeeping where they are needed.
• Time in surgery has many benefits, such as the nurses looking to see who is coming up from surgery.
• Don’t use an interface for the transfers, place buttons were needed.
  Hitting the button is much more effective mechanism for tracking.

To quickly summarize, patient flow changes:

Quantitative Change

• Increase utilization & capacity (volume)
• Increase direct labor productivity
• Reduce overtime & agency premiums

Qualitative Change

• Improve clinical outcomes /reduce errors
• Improve patient and family and satisfaction
• Improve physician and staff satisfaction /retention

Strategic Change

• Enables compliance with new JCAHO standard
• Leverage data (asset) for process improvement
• Seek competitive advantage in marketplace

Technology as an enabler

• Configurable tool to meet unique process needs
• Not tied to CIS/AMR platform
• Intra and inter-departmental platform
• Public display increases accountability, wide distribution of real-time info
• Personal accountability, in recording data and issuing events.

Commitment to improve processes

• Senior management leads multi-disciplinary team/nurses engaged
• Low cost. Non-disruptive data collection process
• Data mining and analysis to support process improvement
• Taking the leap of faith and then keep going.

Opening Day at HIMSS

As a first timer here at HIMSS, I’ve realized you just aren’t going to see everything and do everything. You have to plan carefully and hit what you want to see. The opening was inspiring, but the theme was the same we need to improve and look at the larger picture of information exchange. We are truly and industry where knowledge is power, but there is a timeliness to the knowledge. It needs to be at the time of care.

After the keynotes, I went to the educational session, achieving cost-effective Disease Management. It regarded an early adopter implementation of Soarian Cardiology for disease management of stage 3 and stage 4 congestive heart failure, CHF, patients.

90 million Americans have chronic illness, 70% of the deaths are due to chronic disease – 287,000 relate to CHF. The other component is the cost of care according to the statistics provided 75% of the nations 1.7 trillion expense is in the care of chronic illness.

The other startling factor was the readmission rates of CHF patients at the represented institution the readmission rate was 47%, and CHF took a large portion of the total cost.

Obviously, a problem existed. The goal of disease management is to support the provider/patient relationship and plan of care, prevent exacerbations by using practice guidelines, and provide the tools needed to monitor patient outcomes. Therefore it seemed like a good fit to enable the tracking of the patient, reducing hospitalization/ed visits, and improving communication among providers.

The first step was to obtain physician acceptance in utilizing the system. It really isn’t worth a lot if the doc’s don’t use it. So in order to obtain buy-in, the concept was present to Administration, IS Committee, and Physicians. The planning was a team effort between the physicians, IS, and the vendor, and it was proposed to beta the implementation at a small, easilty monitored and managed beta site.

The Implementation needed a detailed workflow mapping from two points of view, the patients and the employees. For the patients, the look was to see with whom the patients interact and where they go for other departments. From an employee perspective It was to discover if there was time to have RN’s dedicated to enroll and manage patients in the system.

A CHF Management program was established. Within the program there is patient participation in their case, as they call in vital signs, sometimes using a device to interface this information. Phone calls are established asking standardized questions. These questions are normally asked by an RN. Also regularly scheduled office visits are necessary. A cool idea was to graphically show a picture of the improved health of the patient to the patients of the changes in diet, weight, and blood pressure, it really encouraged compliance.

In order to succeed the plan was to take an aggressive enrollment of patients, so every patient was informed about the program as a part of the office visit. Also all local family practicioners were informed.

One of the issue of implementation was that the southern dialect had an impact on the telephony’s system ability to interpret responses. The vendor took a surprising tack and worked specifically with the patients that had a strong accent affecting the equipment. This was nice to see.

In order to maintain improved compliance, if the patients missed a check point, a phone call would be given to ensure they were in good shape. Although this type of followup was viewed as big brother watching, it did improve patient compliance and active participation.

The ROI for this project was seen in the availability of hospital beds for capacity planning due to the decreased readmissions. Downstream revenue as preventive care measures were provided.

An audience member had a really good point to have the disease management system deployed across all comorbidites would see a significant improvement.

All in all it was a good session, even if the statistics provided were just of this institution.

The next session was on creating long term, successful technology partnerships. The panel comprised the industry heavy-weights, CIOs from Memorial Sloan-Kettering Cancer Center, Froedtert & Community Health, John Hopkins University and Health System, and University of Kentucky Chandler Medical Center. Quite a good mix of leaders!

The overwhelming sentiment of the session was that execution is key, and good contracts lead to good partnerships which leads to good execution.

Recommended honesty in expectations in the negotiations, one needs to be honest about the requirements and culture of our institution, and the vendor needs to be honest about the products features/functions. There needs to be a sense of commitment to the partnership and to the success of the project. One really good idea was to include the project plan in the contract.

The other good point was to go in depth on strategic alliances and use your blue-print contract and spend the time that is needed. However for smaller non-strategic alliances go with the boiler-plate contract.

The panel covered what the qualities of a good partnership are, an eloquent statement truly capture the chasm between the two parties, one is a publicly traded for profit company, the other is a non-profit steward of restricted resources. In order for them to meet on mutual ground there needs to be a spirit of collaboration, continuous communication, candid concise clear expectations, and a commitment to success of both parties. Items to look for in an alliance are a cultural alignment, access to senior management, and access to technical developers.

Next the panel covered the myths of contracting.

The first myth is that one must use the vendors contracts, again this is a false hood. The recommended approach is to use a master services agreement for large contracts and a minor agreement for smaller contracts.

The next myth was that famous line about not agreeing to risk based contracts because of ‘Revenue Recognition’ or ‘Our Accountants won’t allow it’. A nice line that overcomes this negotiation tact is that vendors should not inflict their internal constraints on us.

This was followed by the myth of needing to have a signed contract before any project planning or assigned personnel are dedicated. The approach to mitigate this negotiation tatic was to have the selection committee narrow the decision down to two vendors, then as a part of the negotiation with both vendors have language which covers the rights of refusal for expertise in our sole judgment, and take the time required to get a complete plan in the contract.

Points arose around the fact that is impossible to anticipate everything, so to include contingencies is necessary but so are adjudication steps. Remember contracts are also guidelines to relationship management. Project planning is where the true meeting of the minds occurs. An aside is that the value of project plans can not be understated, more comprehensive skills are needs, as project management is a science that blends with the art of project management.

Another myth covered was that vendors will not do risk/reward or fixed fee contracts. A fixed fee contract is that if either the vendor or the institution is unable to deliver a product within a time, penalties are incurred. Such a contract requires careful attention to ensure terms and conditions are being adhered to and nurtured.

Items that must be kept in the communications is what is wanted and what is expected. Targets must be achievable within a fixed fee, risk/reward contract. Also system acceptance is way after live, Sloan gave an example of one system acceptance was a % improvement in AR Days until final billed, and in order to achieve that the vendor comes back on site for best practice reviews and visits.

A fully endorsed tactic was to engage in dual track negotiations all the way through to signed agreement, negotiating terms and price simultaneously. This manner is that both of the recommended vendors from the committee are chosen and aggressively negotiated with, including project plans.

Finally a favorite situation of mine popped up, when the business unit tells you they have selected vendor X and they have already informed the other vendors they are out of the running. In order to overcome this risk, a re-education of the departments, perhaps even detailing the mistakes made in destroying the competitive environment. Another idea was to explain the amount of the commission in tangible dollars, ie the commission for this sale is the price of a Ferrari or reviewing a Master Technology Agreement with all the department heads at once, it is good practice to include the office of general council and supply chain purchasing. Also enlightening the business unit about the hazards of losing negotiating leverage, a conversation with both vendors, explaining as IT we have business obligations but we make the choice and we need to do appropriate due diligence. Due to the enormous risk, it is a best practice to have any technology contract funneled through IS.

The final point on a risk/reward contract was that it is conducive to something and yet not to others, if you are unclear as to where you want to be as an institution, this is not a good contract mechanism.

For me, it was very informative the different tactics needed to take. I’ll continue with a further review a little later today, I’m off to the convention floor.

HIMSS MSHUG

It is going to be a busy week, and I’m looking forward to my first HIMSS experience. I must say San Diego is breath takingly beautiful, and having lunch yesterday with pals by the arena was a pleasure. In February the temperature is above 40 and there is sun! A true joy for a new Englander like me.

Started the day attending the MS-HUG Tech Forum, the welcoming address clarified Microsoft’s strategic view of HIT focused on changing the health organization from a vendor centrix to a technology centric growth. Seems very high level out of the box thinking from my narrowed prespective, imaging a technology centered view of when evaluating vendor selection.

There was a good pyramid of the different architectural views, amazing what can be done when we focus away from the fires of the day.

A cool idea present is to have share point for portals made on the different user communities, clinician, student, researchers, employees, and most importantly patients. Imagine an interactive chronic disease portal and the enhanced benefits of that informational exchange.

Blackford Middleton, MD performed the keynote presentation. It was truly representative of the clinician’s side of the problem, and the frustration exhibited. Due to our disparate, unintegrated systems, it is almost impossible to deliver quality of care at the time the patient presented. It’s impossible to assess the facts, correlating and diagnosis, when one just can not get at the information.

The truth of the matter is that the ROI on any clinical data capture benefits are soft, and it is difficult to prove the value until the system is in place. One example was Brigham’s which saw a 1 million dollar a month benefit
in improved charge capture. Another is the benefits of embedded analytics and decision support, a continuum of clinical decision support. Once the data is reported in an informative manner, clinical documentation will improve by leaps and bounds.

For implementations several good ideas were shared, one of which was displaying a running tally of radiology and lab charges within the longitudinal medical record. Longitudinal medical records refer to the record that is captured over the life of the patient. Another good point was to create medical reminders for consequent or corollary orders.

Along with reminders, there was an example of ten year old business logic hidden within edits on the front end of a system, with no authorizer or owner, and created serious charge capture implications. So a point was to identify who requested what rules, and a yearly review process for rules was recommended.

One surprising point is to ask the question why was that the least beneficial and most costly integration is HL7. The best end result is anticipated to be the symantec web with SOA architecture.

A note to self is to check out documentum document management systems and get a copy of the presentation.

The next presentation was on the New Zealand Health IT Cluster. To summarize New Zealand had a state mandate to implement a collaborative system that provides an integrated view of information from disparate systems. In order to do this all systems collaborate through a health collaboration engine using HL7 Messaging and a Health Services Directory which contains where the patient has been seen and by whom. A good concept shared was to indicate previously chronically diagnosed diseases as a part of the enterprise MPI. One would think allergies maybe beneficial here also.

The collaborative approach indicates that there are several participants in the care of a person, including the individual. All should have access to at least some level of the data to improve quality or care. Obviously it would be important that the exchange be standards based and secure. Also the information is displayed in the UI in an easily digestable. (bulleted) format.

The lessons learnt from our friend across the sea was that a federated model does indeed work, and project management is crucial. A key point was the legacy db was fox pro, not a mainframe wonder.

Next we listened to a case study on the Ann Arbor Community Health Data Exchange, which had 4 separate EMR updating a centralized repository. Before exchanging paperwork was hindering the quality of care, and engaging in a information exchange positions one well strategically for the pay for performance changes later on down the road.

One of the key success factors was community agreement as to what components will be utilized and which components will be excluded. For example substance abuse is not pushed to the centralized repository.

A lesson learned and passed onto others was that workflow is very important and needs to be captured before hand. Also having workflow be closed loop has benefits. The example that really proved this was the automation of the referral process.

Kevin Carr, MD, gave one of the best presentations of the day on developing trust in a health information exchange. The main point of the presentation is that software must reflex what happens in reality, and how will IT support the real world.

The Waterbury health access program is a healthy community federal grant that has two phases first how to get the low income and / or uninsured into health care and then once they are being seen how to keep them in a care and manage that care appropriately.

One key component is patient access and spreading the wealth across family practice physicians. This is managed by a case management combonent so the distribution is evenly dispensed.

The other component is how to manage patients within the system for disease management. The idea was that sharing certain pieces of the clinical record across competing institutions. The solution is that selected information from the disparate longitudinal patient records are exported to a federated web portal. Also inorder to move into the future, we may need to forget past indiscretions and move forward. Wise Words in the politically charged healthcare environment.

Another Key idea was that because this is a community a regulatory body with equal participation from all community data inputs owns the data, having membership from the state and board of health as tie-breakers, if needed. For example a report request and resultant format is sent to a central advisory board, this board then justifies the creation of the report in the format. Any scope changes of the report must also go through the committee.

In a community setting with competing operations, a tack to manage the project is transparent management with unbiased physician and administration leadership. It is absolutely necessary not to have favorite or a “golden operation”, because that will only begin to have the competing operations sparing again.

As with all startups, a sustainability plan needs to be established for the cost of participation after the “seed” grant money is exhausted. The tactic take here was to spread the maintenance cost evenly across the competing operations.

Final a technical infrastructure or architect needs to be establish. Is a centralized or federated model applicable? Surprisingly, this decision is more politically charged then technology charged.

And finally what is Trust?

Treaties and teamwork
Regulatory body
Unbiased PHYSICIAN leadership
Sustainability plan
Technical infrastructure

The next presentation covered a LHIO (localized spin on RHIO). The problem was there were two local paperless independent organizations, Saint Francis Heart Hospital and Cardiology of Tulsa, so before the LHIO the practice was to print, fax to the other institustion, so the other place could scan and import. Basically the automation created two digital islands with humans serving as the bridge.

So to bridge the chasm an interoperability was the pavement, with security as the foundational gravel underneath.

A quick break for lunch and then we were all awoken with the need for a National Health Information Network. Currently we are one of the few remaining industries that does not have all the necessary information available for a customer when they present. And the cost of healthcare is transferring from the employers to the government to finally land on the consumer or patients. Even day to day seemingly simple efforts are bearish, ie immunization records.

The other benefit would be improvement on medical errors, statistics provided in the presentation on Medical Errors.

Due to Medical Errors currently 44,000 – 78,000 Americans die and 770,000 people are injured. In asking the freakonomics question, I wonder how that relates to other portion of statistics. How many injuries are there of handguns?

The only solution is to share data across everyone, but the question is how to get there. IMHO, the cost is very high, and a visionary is needed or a government mandate.

Finally the evening ended with a dinner among my colleagues over at Trattoria la Strada. All in all a great way to spend the day.

Although secretly, I’m itching to hit the convention floor, maybe tomorrow…..

Crystal Reports for Eclipse Preview

Just a little registration, and an email then a nice preview of Business Object's Crystal Reports for Eclipse is available for download. Check it out here.

The Crystal Reports Designer has been revamped for the Eclipse platform. The web application distributes reports in jsp format. A great report distribution tool, and a very enabling move by Business Objects.

Just think a tool to distribute, Siemens Signature DSAR and Invision Reports!

Government Reporting is not the only usage

Here in NY State, there is the State Planning and Research Cooperative System, SPARCS. Among the many data elements that are reported, there are a couple that need to examined for the benefit they would have to improve the quality and consistency of care for example, Race and Ethnicity.
While surfing this morning, another study conducted by the National Public Health and Hospital Institute found the few hospitals are actually using the data to improve the quality of health care that is delivered to patients.

Lesson Learned: If it is needed for governmental statistics, check with the quality department or medical informatics to see if it can improve quality of care.

VMWare Server is going free

Sick of juggling multiple servers for development, or have some really outdated equipment running still needed applications, check this out.

VMWare Server is available as a free product for server virtualization.

VMware Server will be a free product for server virtualization. This is, frankly, a market-changing move, and one that I expect a lot of people will take advantage of. Server virtualization is where you have a single physical server, and partition it into multiple virtual servers. The virtual servers appear independent, more bang for the buck.

Look at the whole ball of wax

Yesterday was an interesting day work wise, I started off the morning doing an analysis of where my team spends their time. It is a part of the monthly routine, I'm trying to standardize. One of my foundational beliefs, is that we work to improve or enhance the place we work. So my goal is to have us spend a large portion of our time doing projects enhancing systems and work processes. When items are built, it should be done in an automated fashion, so we are not constantly having to spend resource time, operationally maintaining a system. Ideally, the business partners are also not to spend a great deal of time operationally maintaining a system.

The truth of the matter is that uninformed programmers may have different goals than the organizational goal. The other item is that timelines may have been rigorous and the end product is a manual interface. Sometimes the individual tasked just doesn't have the needed skill, or sometimes there is the niche builder who creates a niche of dependence for job security. There can be and are alot of reasons, and inheriting a process afterward is enlightening to say the least.

So yesterday, in my analysis I found we were spending the same amount of time resolving break fix items as project work. In my head, and due to the type of organization we have, I believe this should be a 2 to 5 ratio versus a 1 to 1. So it was a challenge for us to identify the root cause and fix the process at hand, and low and behold two main items came up. Both I'm going to share, just mainly because there are times I need to remember the high points.

First, we have an inherited manual process to generate the patient days and patient census, for the week and month. The code is even to the point where portions need to be highlighted, run, results checked, and then depending on the results another portion checked. The data extraction, load, extraction is mostly automated, with several uncontrolled breakpoints that a dependent on a string of processes, so it needs re-engineering. The reporting is all manual, and will need to be moved to another tool inorder to automate CF7 or Crystal Enterprise. Surprisingly even the extraction query for the report is also manual. Any way, the previous programmer built a table that needed to be updated yearly. The really frustrating part that cropped up yesterday, was that it needed to be updated yearly with the following information.

Days Month Year
31 January 2006
28 February 2006
31 March 2006

I think you get the general idea, and definitely not the way one should continue going forward. So we had to change the process, but the table was filled with yearly month days from 2001.

And a key item here, is that patient days and patient census, are pretty standard needs within a Registration/Billing System, why do we even have to do this in a separate and distinct system? So the investigation will continue to find what was the root cause to create this system.

Another process that has been manually done from 1999 was also identified. It is an interesting mix and done daily.

First, we take the data from an operational data store and place it in a file.
Then, we have a scheduled vb program on another machine which copies the file from one server to another.
Next, we have another scheduled vb program on another server, different server from previous step, that takes the file, strips off the cpt code and date of service and uses access 97 to create an autoidentifier. A file is then created with the autoidentifier instead of the cptcode and date of service.
Next, a person manually copies this file from the place it is created to another server (which is a development platform).
Next, the file is encrypted on this testing server and ftped to the remote site.
Next, the ftp program checks to see if any files are available for download and picks them up, unencrypts, and sets them on yet another server. (Autoidentifier is no longer on the file)

We are still trying to discover what happens to the file after this point in time, but it looks like all we need to do is get the current specs of the output file from the receiving system and just write code to get it from the data store, and send it encrypted to the end location.

So the lesson learned here, is that you have too look at the whole process the sum of the parts, and streamlining may be simplier. While fixing these two of many processes are not resume worthy by any means, to me it is just a couple of steps closer to the ideal, and our team has truly started to adopt the philosophy.

High Road

Unfortunately in work environments now a days, the high road is the road less travelled. What does it mean to take the high road, it means forgiving others quickly, learning to serve the greater good, not getting even, and not keeping score.

It is difficult at times not stoop to the lower level, but the end result is that one needs to know how to be comfortable within your own skin, and sometimes after lying down in the mud, it is not that easy to get clean again.

In the middle of large projects, sometimes even smaller ones, life gets stressful, and people act uncharacteristically. To be frank, this is not a good place or time to continue infighting. It is a time to act as a team, everyone has a valuable point, and honestly we can accomplish alot more together than apart.

Project Status Updates

Every so often, we need to have project status updates just to clearly identify who is doing, what and when, and how it is going. What is sometimes bewildering to me, is that although status updates are common place, they are perceived as an annoyance by the responsible parties.

So what is in a status update, at a high level, what is being worked on, what's next, and what was done. If you are on the end stage of a project or reviewing outstanding issues. A format that works for me is:

Issue Identification:
Summary:
Responsibility:
Current Status:
Next Step:
Accomplishments:
Decision:
Follow up:

It is a pretty easy format, and clearly describes responsibilities. Also it yields a useful summary of information of where the issue status.

Free XML SPY

One of the nicer XML tools now has a free home edition. The XMLSpy Home Edition makes XML editing technologies available for hobbiests, entry-level programmers and students. A great teaser for the professional and enterprise tools.