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Technology advances are rapidly affecting the healthcare industry. Mobile technologies are enabling processes with power not long ago reserved for large computers. Better, faster, cheaper and definitely smaller is evident in the amazing technologies being deployed in the medical devices – from smart pumps to implantable defibrillators. Diagnostic equipment too has advanced in capability due to “computer on board”. The technologies of medical devices and information systems are converging.
Convergence in this context creates challenges for those tasked with the maintenance and operations of the technologies. In most organizations, medical devices are maintained by biomedical engineering whereas the computer systems are supported by the information systems department. Who maintains the “computer on board” the new million dollar whatchamacallit? Biomedical professionals are not historically trained to be concerned about interfaces, file back ups and system reliability. Conversely, IT folks don’t like to get too close to things that could harm a patient. I have heard from CIO’s who have been asked to confirm the supportability of a gamma knife (non-invasive surgical instrument used on brain tumors). If the CIO is not the authority, then who is? We’ve come a long way from making sure that payroll got out on Friday.
Dan you make some interesting points here. Convergence is a tough nut to crack in the Healthcare IT space. And the question of just who is responsible for the integration of technology has been the subject that has been addressed across many Board tables for a long time and, unfortunately, the subject of a lot of finger pointing.
As a former CIO for a major healthcare facility, part of my responsibility was as a visionary for the Hospital - somewhat of an ambassador for new technology - to enure that we were up-to-speed with the latest technology and also to esure that it could some how be integrated into our legacy system at the hospital and the surrounding campus facilities.
I was successful not because I had my hand on the pulse of the latest and greatest - I was too busy for that - but I was succesful because I relied on a team - myself, my staff, the campus’ Chief Healthcare Solution Architect and, most importantly, IT Solution’s Firms and Integrators such as your organization. There needs to be a larger push in the industry to have firms such as yours plan technology integrations hand-in-hand with the Healthcare providers, etc. and not just be brought in at the last minute to “try” and make everything work properly. We are dealing with healthcare - the care of human beings - enough said.
If you would like your readers to check out another Healthcare blog see http://blogs.msdn.com/rruggeri/default.aspx.
I look forward to your comments.
Effective CIO’s certainly function as the ambassador for technology in the modern healthcare organization and relying on the team is critical to their being able to have the time to strategize. Thought leadership in the industry is definitely a shared responsibility and qualified system integrators work to stay in touch with emerging or “leading” practices - I always hesitate to promote “best practice.”
I wonder if this is the start of another evolutionary phase in the role of the Healthcare CIO where it might make sense to consider adding “ownership” for Biomedical Engineering to the portfolio of CIO responsibilities? Looking at that CIO portfolio today provides “archeological” evidence of other changes in scope of CIO responsibility, reflecting challenges at the time including functions such as Telecommunications/Call Centers, Decision Support, Medical Records – even Industrial Engineering. Senior industry folks will recall that HIMSS originally was “the engineer’s society” where organizations such as ECHO where were the hard core IT types gathered.
My sense of this challenge is that it is more anchored in organization culture and change management than in new science. What would it take to have the conversation in your organization about the integration of Biomedical engineering with IT? What are the skills required to support this operating model characterized by Convergence? Where are the gaps? How much of the gap is related to establishing service level agreements and then aligning budgets to support those? Much as we like, we can’t slow down Convergence – we can only prepare for it.
Hi Dan – Thanks for your response.
I too believe in not promoting best practices, especially in the healthcare industry. I have found that through trial and error that a “best practice” for one is not necessarily the “best practice” for many or the masses. As you know, in many cases, healthcare is not an exact science…our bodies merely machines…as someone once wiser than I said.
I agree with you that there is, or should be, an evolutionary phase to add Biomedical Engineering to the CIO portfolio. But how does the market and the educational system ready this truly complex responsibility for this role? True the CIO portfolio has grown over the years to your point – telecommunications and call center responsibility, decision support, medical records and, as you mentioned, even Industrial Engineering. But we need to be careful – were these areas or responsibility forced into the CIO portfolio? – probably so and without adequate or equivalent expertise in the area. So we, as seasoned professionals, need to be cognizant of these factors and consult accordingly.
At BIOSTEC 2008 – the International Joint Conference on Biomedical Engineering Systems and Technologies held in Portugal, one of the keynote speakers spoke about Biomedical Engineering and the integration of IT. It was a fascinating lecture entitled, The cancer informatics ecosystem: A case study in the accretion of federated systems based on SOAs, semantic integration and computing grids.
The keynote speaker was Dave Hall who is a Senior Software Project Leader at RTI International based in NC. He leads a team of 30 developers implementing computer systems that support large biomedical and biotechnological research enterprises in cancer research, pharmacological discovery, genetic epidemiology and plant biotechnology. This gent holds a Ph.D. in Genetics from the University of Georgia and a B.S. in Computer Science from Wake Forest University. Of the many topics that he touched upon, two of the topics were of particular interest: systems integration, and high performance computing in the HC space.
He also touched upon, although not a focus of his speech by far, and just a mere mention, was the responsibility of the IT market to foster CIOs that are prepared, educated and knowledgeable in the medical sciences field – especially for HC facilities, etc. He suggested that the industry needs more CIOs that have MD and PHd degrees, pharmacological degrees, BS or MS degrees so they are better prepared to embrace emerging technologies and act in the best interest of the healthcare marketplace, facitlity, etc. Believe me there were many wide-eyed “seasoned” CIOs in the audience that grumbled as thoughts of a younger generation with more advanced degrees then themselves pushed them aside.
Again as a healthcare professional, I look back at my oath and what is best for the patient. What a concept huh? - to bring relevancy and competency to a role to ensure that we are able to support the exploding HC and technological space and support convergence.
The healthcare enterprise requires the effective collaboration of professionals and dedicated staff with a wide array of training, certification and experience. I can appreciate the point of view of Dave Hall from RTI International regarding the value of clinical education and advanced degrees in future CIO’s - it certainly could not hurt. However, I believe that truly effective CIO’s establish teams and infrastructure around them to harness the “best of” contributions from all types of stake holders. So clinical credentials alone will not ensure long term effectiveness as a CIO even as clinical technology blends seamlessly with information technology.
I do see the future need for even more open and collaborative cultures with the healthcare IT organization being a key success factor. Clinical professionals are hired to provide care and related services to patients. They don’t remain patient for very long with bureaucratic IT functions. Just look at how many stand-alone Access Databases exist at the typical Academic Medical Center.
The core business of healthcare needs to have the patient at the center - not the department, not the physician, not the hospital and not the payer. Enabling the safe and efficient delivery of advanced clinical services in the future will truly be a team sport. I don’t think that CIOs need to worry about being pushed out by clinicians looking for a career change - the real push will come from the increased capabilities of new science and the need to facilitate collaboration.
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Keep up the good work!
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Dan,
There is a collaborative effort between AAMI, HIMSS, and ACCE that has been going on for the past year. You can read about it on the website at http://www.ceitcollaboration.org/
Ray
Biomed and IT have grown separately in healthcare organizations for long time, so naturely there is a need for specific governance plan on how to engage them and other services such as Nursing and Facilities in optimal collaboration. Previouisly, it was easy to divide assets into intelegence embeded and other medical devices but these days it is more integrated and requiring integrated management. Couple of weeks ago, I participated in a webinar on this topic that ECRI offered. You can find more about it at: https://www.ecri.org/Press/Pages/CE_IT_Collaboration.aspx
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When all desires that surge in the heart are renounced, the mortal becomes immortal.
Those who dwell on and long for sense-pleasure are born in a world of separateness. But let them realize they are the Self and all separateness will fall away.
The Self desires only what is real, thinks nothing but what is true. Here people do what they are told, becoming dependent on their country, or their piece of land, or the desires of another, so their desires are not fulfilled and their works come to nothing, both in this world and in the next. Those who depart from this world without knowing who they are or what they truly desire have no freedom here or hereafter. But those who leave here knowing who they are and what they truly desire have freedom everywhere, both in this world and in the next.
… all things we desire but do not have, are found when we enter that space within the heart; for there abide all desires that are true, though covered by what is false.
A person is what his deep desire is. It is our deepest desire in this life that shapes the life to come. So let us direct our deepest desires to realize the Self.
Though all the galaxies emerge from him, He is without form and unconditioned.
The supreme Self is neither born nor dies. He cannot be burned, moved, pierced, cut, nor dried. Beyond all attributes, the supreme Self is the eternal witness, ever pure, indivisible, and uncompounded, far beyond the senses and the ego…. He is omnipresent, beyond all thought, without action in the external world, without action in the internal world. Detached from the outer and the inner, This supreme Self purifies the impure.
The truth of the Self cannot come through one who has not realized that he is the Self. The intellect cannot reveal the Self, beyond its duality of subject and object. They who see themselves in all and all in them help others through spiritual osmosis to realize the Self themselves. This awakening you have known comes not through logic and scholarship, but from close association with a realized teacher.
The basic teachings of the Upanishads are summed up in six great sayings (Mahavakyas). These are ? ‘I am Brahman’ (Aham Brahmasmi). ‘The Self is Brahman’ (Ayam Atma Brahma). ‘That thou art’ (Tat tvam asi). ‘Intelligence is Brahman’ (Prajnanam Brahma). ‘The Universe is Brahman’ (Sarvam Khalvidam Brahma). ‘He am I’ (So’ham). These are statements of the identity of the individual consciousness with the Absolute or Divine reality. They all derive from and merge into Om (AUM), the Divine Word of ‘I am all’.
Above all senses is the mind. Above the mind is intellect. Above the intellect is ego. Above the ego is the unmanifested seed, the Primal Cause.
In deep meditation aspirants may see forms like snow or smoke. They may feel a strong wind blowing or a wave of heat. They may see within them more and more light: fireflies, lightning, sun, or moon. These are signs that one is far on the path to Brahman.
Brahman is the first cause and last refuge. Brahman, the hidden Self in everyone, Does not shine forth. He is revealed only To those who keep their mind one-pointed On the Lord of Love and thus develop A superconscious manner of knowing. Meditation enables them to go Deeper and deeper into consciousness, From the world of words to the world of thoughts, Then beyond thoughts to wisdom in the Self.
You are the supreme Brahman, infinite, yet hidden in the hearts of all creatures. You pervade everything.
The Lord of Love is one. There is indeed no other. He is the inner ruler in all beings. He projects the cosmos from himself, maintains and withdraws it back into himself at the end of time. His eyes, mouths, arms, and feet are everywhere. Projecting the cosmos out of himself, he holds it together. He is the source of all the powers of life. He is the lord of all, the great seer who dwells forever in the cosmic womb. May he purify our consciousness!
The Lord of Love is before and behind. He extends to the right and to the left. He extends above; he extends below. There is no one here but the Lord of Love. He alone is; in truth, he alone is.
Meditate and realize this world is filled with the presence of God.
He is fire and the sun, and the moon and the stars. He is the air and the sea, and the Creator, Prajapati. He is this boy, he is that girl, he is this man, he is that woman, and he is this old man, too, tottering on his staff. His face is everywhere. He is the blue bird, he is the green bird with red eyes; he is the thundercloud, and he is the seasons and the seas. He has no beginning, he has no end. He is the source from which the worlds evolve. From his divine power comes forth all this magical show of name and form, of you and me, which casts the spell of pain and pleasure. Only when we pierce through this magic veil do we see the One who appears as many.
Covet nothing. All belongs to the Lord. Thus working you may live a hundred years. Thus alone will you work in real freedom.
Realizing that from which all words turn back and thoughts can never reach, one knows the bliss of Brahman and fears no more.
Brahman is beyond all duality, beyond the reach of thinker and thought.
When the whole mantram … goes on reverberating in the mind, One is freed from fear, awake or asleep…. Established in this cosmic vibration, the sage goes beyond fear, decay, and death to enter into infinite peace.
The mantram is the bow, the aspirant is the arrow, and the Lord the target. Now draw the bowstring of meditation, and hitting the target be one with him.
O Lord, from whom we receive the mantram as a weapon to destroy our self-will, reveal yourself, protector of all.
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