Health IT

My New Year’s resolutions

Health care CIO Dr. John Halamka outlines his New Year’s resolutions, which includes overcoming the fact that many clinicians do not want an electronic health records and “want to be implemented last in any rollout.”

Dr. John D. Halamka is chief information officer and dean for technology at Harvard Medical School who writes at Life as a Healthcare CIO.

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I’ve taken a few days off to travel to Southern California for a holiday family get together filled with seasonal celebration, great meals, a few hikes, and helping my parents around the house.

Now that’s it New Year’s Eve, it’s time to reflect on the experiences of the previous 12 months and evaluate changes I can make in my priorities to improve my work, home, and personal lives. 2009 has been a year that required incredible energy just to keep pace with the changes in healthcare IT. Despite my best efforts in 2009, there are areas that need even more energy and focus in 2010.

1. Use all my skills to support EHR change management – it’s very clear to me that many clinicians do not want an EHR. Meaningful use is an incentive, but many clinicians remain unconvinced that EHRs will save time, improve safety, and enhance their practices lives. They want to be implemented last in any rollout. Implementing hundreds of clinicians “last” is not doable. My role is to ensure every clinician associated with BIDMC understands the current federal, state, and local EHR activities, aligning incentives and building enthusiasm for EHRs, health information exchange, and quality registries. This means that I’ll attend a lot of clinician group meetings and need to ramp up all forms of communication to share updates and experiences with the community.

2. Achieve breakthroughs in web communication tools – 2010 will be the year that we replace the BIDMC intranet, retiring the portal I personally wrote in 1997. 2010 will also be the year that Harvard Medical School moves its external web content to a content management system with distributed authorship. Both these efforts require careful alignment of stakeholders, constant vigilance to ensure alignment of functional requirements with technical capabilities, and active governance committees to serve as a guiding coalition for change. I never want to be so dogmatic that I become an impediment to innovation, so I’ll embrace all the Web 2.0 concepts that both BIDMC and Harvard need to make our web sites – intranet and extranet – a very cutting edge experience.

3. Drive community interoperability efforts – The Federal and State environments in 2010 includes many catalysts – meaningful use/standards/certification regulations, ARRA funding (HIE grants, RHITEC grants, Beacon Communities grants, SHARP grants for research, training/education grants), a BIDMC/Boston Public Health Commission/NEHEN pilot to streamline disparities and surveillance reporting, a BIDMC/MAeHC/NEHEN pilot to accelerate community quality metric reporting and several efforts to support bidirectional EHR data exchange through NEHEN, locally implemented RESTful web services (more about these pilots on Monday), and most importantly evolving multi-stakeholder governance through the Eastern Massachusetts Healthcare Initiative, Massachusetts eHealth Institute and our Beacon Communities effort – Greater Boston Aligning Forces for Quality. Clearly 2010 is the year to push interoperability into every practice and hospital.

4. Support my family – Despite all the change around me, I also need to foster stability for those I support – my wife, daughter, and parents. My wife will be evolving her career from teaching to creating more art in her renovated studio and new gallery. My daughter will be applying to college. My parents will be enjoying their new, simpler house which is ideal for a retirement lifestyle. All these folks will need my heavy lifting, encouragement, and emotional support.

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5. Renew myself – it’s important that I maintain my relevance by adopting new technologies, embracing change, and innovating. Renewal can be technological, philosophical, or personal. The human mind gravitates to new ideas and novel approaches. I want to be at the center of change, inventing it or leading it if possible. I should never be considered a champion of the status quo or an impediment to innovation. How will I renew this year? You can be sure I’ll adopt emerging interoperability technologies that accelerate adoption. I’ll continue to pilot personal refinements as I’ve done in 2009 with riding a folding bicycle to all my Boston meetings while wearing experimental Kevlar clothing. I cannot precisely predict the changes of the next year, but when I see transformational possibilities, I will pursue them aggressively.

The common thread of all 5 resolutions is people – aligning incentives for clinicians, empowering staff with new web tools, gaining stakeholder support for interoperability, ensuring the success of my family, and refining my own approach to life. If I can successfully maintain a focus on the people and treat the bits and bytes as secondary, 2010 will be a great year.

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