Monday, May 24, 2010
Informatics Webinar
So, someone really wanted me to speak about Healthcare Informatics and I complied! Here is the link to the webinar: http://www.expressor-software.com/healthcare-informatics-meta-analytics.htm
Tuesday, April 20, 2010
Competition
No, I didn't get lost on the golf course and am just finding my way back! A client kept me busy...imagine that! But that is not the reason for this post. The reason for this post is "Competition"! Well, if you abstract to another level, it is about "Goals".
Have I managed to confuse you yet? Well then, read on. Things are about to become clearer. So, as I was talking to a potential client, I approached him with the same questions that have listed out in these blogs. One of them was "Have you defined your measures yet?". But before he answered, he said "Kishore, my biggest problem is competition. I often make 40 cents on the dollar, there are several other clinics who offer the same services we do in the general area and I am losing my shirt. Someone suggested business intelligence as a solution, but I have no idea where to start". As I was listening to him, light bulb went off in my head! Folks, I am going to tell you something that I normally don't tell anyone...I was wrong! See, just then, I realized I had made a big assumption. I had assumed that everyone knew they WHY of informatics. Not so. So, here is step 1. Know your GOALS!
How do you define your goal? Well, you know this better than any consultant you will ever hire. Your goals may be to "Save more money" or "Comply with ARRA" or "Need to improve my quality of care". Once you know your goals for your measures, i.e, what are you going to do with them, you now have a good idea of "What to measure". Now you can define the measures and follow the steps I have outlined in my previous posts. So folks, happy "goaling"! (Is that a new word? Hmmm....need to check it!)
Monday, March 15, 2010
Metadata & Master Data Management
Hmmmm...interesting topic, eh? Why bother? What can I do? How much is it going to cost me?
Well folks, I am going to tell you a secret. This is a secret that we, I mean technologists, have hidden from you for long. Much like the wall street "experts" who are now "fixing" the problems they created in the first place and getting paid for it, we are doing the exact same thing. This is an issue that we created (I mean technologists). Now we have cool technologies like metadata repositories and dictionaries that can give you standardized data definitions across the enterprise, but we'll need you to pay us for the "cool technology" we created to solve "your issues"!
Why bother?
Answer is simple. Have you ever had Gatorade? Yellow, Blue, Orange? Well if you have, you get different "flavors" of the same thing. Same thing with business intelligence. If you want to call something a pot, call it a pot. Don't call it pot in one place, a vessel in another and a container in another place. Unfortunately, the reality is just that. A pot is called a pot in one system, a vessel in another and a container in a third. If you tried to print out the value of a "pot" for your CEO to see, you would have to sit there and explain "well, it is the same thing, but it may be called a container on page 2"! You can imagine the reaction. Enter metadata and masterdata management! We take the pots and the containers and the vessels, call it a pot, make sure the attributes of all three are the same, store it in a dictionary and charge you a couple of millions for it! Sound cool? No?
What can I do?
There are things you can do and not break the bank while doing it. Old fashioned discipline and planning, for example. And you, as the healthcare exec, is in luck! Because, if you are like most companies, you have a clean slate to start with, in terms of informatics. So, with a little bit of planning upfront, you can avoid a lot of costs later. Incorporate metadata/master data management into your informatics initiative early on. In other words, don't build a warehouse without it! Just like you put planning and thought into collecting your measures, think of having standard data definitions across the enterprise. Reach out to folks like SNOMED to see what they are doing. Trust me, your upfront costs will be a drop in the bucket if you have to do it as an afterthought. It will also ensure better data quality as the data won't get into your system without rationalizing with your dictionary first.
So when your buddy from the other hospital is worried about his/her metadata, you can simply say, "we have incorporated that into the "front end" of our process", take a long hard look at the fairway, judge the wind speed and let it rip!
Well folks, I am going to tell you a secret. This is a secret that we, I mean technologists, have hidden from you for long. Much like the wall street "experts" who are now "fixing" the problems they created in the first place and getting paid for it, we are doing the exact same thing. This is an issue that we created (I mean technologists). Now we have cool technologies like metadata repositories and dictionaries that can give you standardized data definitions across the enterprise, but we'll need you to pay us for the "cool technology" we created to solve "your issues"!
Why bother?
Answer is simple. Have you ever had Gatorade? Yellow, Blue, Orange? Well if you have, you get different "flavors" of the same thing. Same thing with business intelligence. If you want to call something a pot, call it a pot. Don't call it pot in one place, a vessel in another and a container in another place. Unfortunately, the reality is just that. A pot is called a pot in one system, a vessel in another and a container in a third. If you tried to print out the value of a "pot" for your CEO to see, you would have to sit there and explain "well, it is the same thing, but it may be called a container on page 2"! You can imagine the reaction. Enter metadata and masterdata management! We take the pots and the containers and the vessels, call it a pot, make sure the attributes of all three are the same, store it in a dictionary and charge you a couple of millions for it! Sound cool? No?
What can I do?
There are things you can do and not break the bank while doing it. Old fashioned discipline and planning, for example. And you, as the healthcare exec, is in luck! Because, if you are like most companies, you have a clean slate to start with, in terms of informatics. So, with a little bit of planning upfront, you can avoid a lot of costs later. Incorporate metadata/master data management into your informatics initiative early on. In other words, don't build a warehouse without it! Just like you put planning and thought into collecting your measures, think of having standard data definitions across the enterprise. Reach out to folks like SNOMED to see what they are doing. Trust me, your upfront costs will be a drop in the bucket if you have to do it as an afterthought. It will also ensure better data quality as the data won't get into your system without rationalizing with your dictionary first.
So when your buddy from the other hospital is worried about his/her metadata, you can simply say, "we have incorporated that into the "front end" of our process", take a long hard look at the fairway, judge the wind speed and let it rip!
Wednesday, January 27, 2010
Golf is like Business Intelligence!!
I was at the golf course this past weekend. As I was having a "heart to heart" conversation with the course (ok, it was more like me pleading to the course), I realized how much the game of golf is like investing in BI.
Let's take a look. Golf is unlike other games we play. For example, if you want to play soccer, you'll go get a ball, get 22 of your friends together , find an open space and take four sticks and stick them at the opposite ends for goal posts and you are ready to go. Not with GOLF!
Even before you set foot on the course, you have to buy a set of clubs. ($2000 for a decent set). Balls - $15.00 a dozen, unless you want the soft core max distance "I can fly like a bird" kind.
Tees - $1.50
Gloves - $16.00
Shoes - $150.00
Attire ; $100.00
Lessons (unless of course you want to invest in more balls and be the laughing stock of your buddies) - $500
Round of Golf - $50.00
Your game? - Sketchy at best for the first few rounds.
Now let's look at your BI initiative:
Hardware - Depending on how many you buy, could go upto $150K.
ETL Software (Server licences) - $750K
ETL Software (Developer licenses) - $150K
Database Server license - $100K ( Again, depending on how many you buy, this could go upto $500K)
BI Server License - $60K
BI Developer Licenses - $2K
Now, you have the equipment. Next step? Hire a Golf Pro (Usually known as Big Six consulting firm) to do a gap analysis and come up with a roadmap for implementation - $200K
You can't go golfing without your buddies now, can you? (Well, if you are like me and obsessed with the game of golf, you might just do that.) But I am not talking about us corner case scenarios then, am I? Let's call your buddies your implementation team. Total cost over a period of 8 months of implementation? $1.9 M
So, like the game of Golf, even before you set foot on the course, you have spent about $2M. Then, after the round of golf (implementation period), about $4M. Get the picture? ROI??
What can you do to avoid costly mistakes?
Step1: The first thing to do is to go through the "Measure Everything That Really Impacts Customers (METRIC)" process . Once you have the repository of metrics and have decided how you want to see your data and how often, then you can go to step 2.
Step 2: Prioritize your measures according to business need. Apply the 80/20 rule. Basically, 20% of your metrics should give you 80% of the value.
Step 3: Evaluate technology solutions that fit your need
Step 4: Purchase
Step 5: Implement
Step 6: Test and Deploy
Maximum value can be achieved with a little careful planning upfront. Now, you can go play a good round (and if you are in Jacksonville, call me for that round) of golf knowing that your BI initiative is better than 60% (according to Gartner) of the initiatives out there!
Let's take a look. Golf is unlike other games we play. For example, if you want to play soccer, you'll go get a ball, get 22 of your friends together , find an open space and take four sticks and stick them at the opposite ends for goal posts and you are ready to go. Not with GOLF!
Even before you set foot on the course, you have to buy a set of clubs. ($2000 for a decent set). Balls - $15.00 a dozen, unless you want the soft core max distance "I can fly like a bird" kind.
Tees - $1.50
Gloves - $16.00
Shoes - $150.00
Attire ; $100.00
Lessons (unless of course you want to invest in more balls and be the laughing stock of your buddies) - $500
Round of Golf - $50.00
Your game? - Sketchy at best for the first few rounds.
Now let's look at your BI initiative:
Hardware - Depending on how many you buy, could go upto $150K.
ETL Software (Server licences) - $750K
ETL Software (Developer licenses) - $150K
Database Server license - $100K ( Again, depending on how many you buy, this could go upto $500K)
BI Server License - $60K
BI Developer Licenses - $2K
Now, you have the equipment. Next step? Hire a Golf Pro (Usually known as Big Six consulting firm) to do a gap analysis and come up with a roadmap for implementation - $200K
You can't go golfing without your buddies now, can you? (Well, if you are like me and obsessed with the game of golf, you might just do that.) But I am not talking about us corner case scenarios then, am I? Let's call your buddies your implementation team. Total cost over a period of 8 months of implementation? $1.9 M
So, like the game of Golf, even before you set foot on the course, you have spent about $2M. Then, after the round of golf (implementation period), about $4M. Get the picture? ROI??
What can you do to avoid costly mistakes?
Step1: The first thing to do is to go through the "Measure Everything That Really Impacts Customers (METRIC)" process . Once you have the repository of metrics and have decided how you want to see your data and how often, then you can go to step 2.
Step 2: Prioritize your measures according to business need. Apply the 80/20 rule. Basically, 20% of your metrics should give you 80% of the value.
Step 3: Evaluate technology solutions that fit your need
Step 4: Purchase
Step 5: Implement
Step 6: Test and Deploy
Maximum value can be achieved with a little careful planning upfront. Now, you can go play a good round (and if you are in Jacksonville, call me for that round) of golf knowing that your BI initiative is better than 60% (according to Gartner) of the initiatives out there!
Monday, January 11, 2010
The Biggest mistake some Health IT Executives will make this year
Now that the Interim Final Rule for "Meaningful Use" has been published and the reporting requirements are clearer, what is the biggest mistake one can make this year? Go out there, buy and implement an EHR solution! No, I didn't wake up on the wrong side of the bed this morning. Nor was there any "extra something" in my coffee! Let me explain.
The basic premise of "meaningful use" is to achieve two things.
1. Improve Quality of Care
2. Reduce Cost of Care.
Now, there will be some EHR solutions out there that will satisfy your government mandated reporting requirements. The question is, will that help reduce the cost of care or improve quality of care? The answer is a resounding NO! Why? The EHR solution, web-based or otherwise, is only going to add another silo of data in your organization. It's not going to show you the "correlation" between "Central Line infection rates" and the cost of care. It's not going to show you the correlation between "Average waiting time" and loss of revenue associated with patients leaving without being seen. Nor will it be able to historically report on the "Percentage of patients given smoking cessation counseling" and how that has improved "quality of care".
So, blindly implementing an EHR slution is only going to add another department that you have to manage. Another silo, collecting data, without producing any "meaningful use" for your organization.
So, while you are in the process of evaluating EHR software, consider the TCO and ROI for those investments. Consider how you can leverage the data being generated to add profitability to the business. Consider how you can leverage your existing data and add some "real intelligence" to the business.
The basic premise of "meaningful use" is to achieve two things.
1. Improve Quality of Care
2. Reduce Cost of Care.
Now, there will be some EHR solutions out there that will satisfy your government mandated reporting requirements. The question is, will that help reduce the cost of care or improve quality of care? The answer is a resounding NO! Why? The EHR solution, web-based or otherwise, is only going to add another silo of data in your organization. It's not going to show you the "correlation" between "Central Line infection rates" and the cost of care. It's not going to show you the correlation between "Average waiting time" and loss of revenue associated with patients leaving without being seen. Nor will it be able to historically report on the "Percentage of patients given smoking cessation counseling" and how that has improved "quality of care".
So, blindly implementing an EHR slution is only going to add another department that you have to manage. Another silo, collecting data, without producing any "meaningful use" for your organization.
So, while you are in the process of evaluating EHR software, consider the TCO and ROI for those investments. Consider how you can leverage the data being generated to add profitability to the business. Consider how you can leverage your existing data and add some "real intelligence" to the business.
Tuesday, January 5, 2010
Why Informatics?
Now that I am back from a little time off, let's look at the very basic question, Why Informatics? How does this work in healthcare? What are the reasons why I should even think about it? And I am over the subject of the cloud, just so you know.
Savings!!
If you are seriously considering reducing cost of care, the only way to do it is through knowledge. I mean, knowledge of your business. What are my central line infection rates? What is the average waiting time for my patients? What is the average bed occupancy rates? Having answer to these questions and many more will help you produce an effective strategy to make your business more efficient. Efficiency will then translate to savings. We all know that.
Legislation/Compliance!
If you are not already on top of this, please take some time to read through it. You will avoid a lot of heartache down the line. ARRA has some 20 odd measures that you have to report on. With penalties associated with it, if you don't comply. But other than that, when you are looking at an informatics solution, you should probably think ahead to more than just those measures and how implementing a comprehensive solution will affect the bottom line of the business. Also, you could be missing out on the Medicaid funding allocated to provider organizations under the ARRA. $2-$8M allocated for hospitals and $44K allocated for individual physicians. ROI is very evident.
That's about it.
Savings!!
If you are seriously considering reducing cost of care, the only way to do it is through knowledge. I mean, knowledge of your business. What are my central line infection rates? What is the average waiting time for my patients? What is the average bed occupancy rates? Having answer to these questions and many more will help you produce an effective strategy to make your business more efficient. Efficiency will then translate to savings. We all know that.
Legislation/Compliance!
If you are not already on top of this, please take some time to read through it. You will avoid a lot of heartache down the line. ARRA has some 20 odd measures that you have to report on. With penalties associated with it, if you don't comply. But other than that, when you are looking at an informatics solution, you should probably think ahead to more than just those measures and how implementing a comprehensive solution will affect the bottom line of the business. Also, you could be missing out on the Medicaid funding allocated to provider organizations under the ARRA. $2-$8M allocated for hospitals and $44K allocated for individual physicians. ROI is very evident.
That's about it.
Friday, December 4, 2009
Cloud, cloud, cloud!!
Alright, now that I have your attention by throwing out the biggest buzzword of recent times (watch it, if I still don't have your attention, I might start talking about 2012!!), I cringe every time I hear the word Cloud Computing being equated with "redundant data storage", "ASP" (application service provider) model applications, "load balancing" and "SaaS". Can I throw out some simple definitions out there? No? Well, I am going to, anyway!
SaaS - Software as a Service. Much like leasing a car. Instead of paying a one time purchase price, you pay over time. It is not new architecture or software, folks, it is a method of payment.
Load Balancing - You call in to a call center. "Please hold while we find the next available representative....". Not new architecture or software. Just finding the next available resource to answer your question.
ASP - Application Service Provider. Bill Pay Online anyone? Also, see SaaS. Not new architecture or software.
Storage of Data at Multiple Locations - Redundancy? Mirroring? Disaster Recovery? Not new architecture or software.
So, my dear sales person, please read Wikipedia before you call your application "Cloud enabled" or "water vapor" or any new term that your marketing folks thought up.
Internal Directive to Meta Analytix employees:
Starting immediately, please re-do our website and use the word "Cloud Computing" everywhere.
Sales: Please tell everyone our products are "SaaS enabled" and "Cloud Enabled".
Marketing: Please come up with some snazzy terms. I am thinking "SaaSy" or "Cloudy"
Technology: Enjoy your vacation. I will see you all next year.
--Your President
SaaS - Software as a Service. Much like leasing a car. Instead of paying a one time purchase price, you pay over time. It is not new architecture or software, folks, it is a method of payment.
Load Balancing - You call in to a call center. "Please hold while we find the next available representative....". Not new architecture or software. Just finding the next available resource to answer your question.
ASP - Application Service Provider. Bill Pay Online anyone? Also, see SaaS. Not new architecture or software.
Storage of Data at Multiple Locations - Redundancy? Mirroring? Disaster Recovery? Not new architecture or software.
So, my dear sales person, please read Wikipedia before you call your application "Cloud enabled" or "water vapor" or any new term that your marketing folks thought up.
Internal Directive to Meta Analytix employees:
Starting immediately, please re-do our website and use the word "Cloud Computing" everywhere.
Sales: Please tell everyone our products are "SaaS enabled" and "Cloud Enabled".
Marketing: Please come up with some snazzy terms. I am thinking "SaaSy" or "Cloudy"
Technology: Enjoy your vacation. I will see you all next year.
--Your President
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