Christmas Eve for Healthcare IT – Assembling Other People’s Toys

How many major projects does your Hospital IT department have going at once?

I just returned from the regional Midwest  HIMSS conference where we had a booth to demonstrate my company’s immense breadth and depth of knowledge in the hospital marketplace. It was a great show. We spoke to a lot of great people.

The day before it started, I arrived at the booth, dumped out all the parts needed to assemble the booth and assorted equipment and then had a sudden flashback to Christmas.

As any good parent knows, Santa does all of his work on December 24^th in a frenzied 12-24 hour period of realization that whoever decided for him that all this should be done in one night was not a good project manager. As kids get older, Santa has more and more complex toys to assemble.

As in the trade show booth, I usually just open the boxes, spread everything out onto the floor and then figure out how to make it work, hoping I have the right tools or at least that my son didn’t  take the drill and leave it discharged in a pile of dinosaurs.

Last year I made the mistake of opening a kitchen and a racetrack at the same time. It didn’t seem like it would be an issue: the parts look nothing alike but, in retrospect, the total scope of the mess I hadn’t really appreciated beforehand.

Actual stock photo of the Costco kitchen that ruined my Christmas Eve. My wife was thrilled.

This image of a father sitting down to put together some incredibly complex toy with hundreds of parts, screws, glue, stickers and a hard deadline translates well to what Hospital IT departments now have to deal with as they are currently in the throes of implementing many complex software/hardware packages that may or may not play well together.

What to do first? Do I have the tools? Do I have enough people to do the heavy lifting? How much did that cost? My deadline is when?

Now for most HIT departments, this mess isn’t their doing.  Someone from up on high, with impetus from the government, board members, physician community has pretty much decided to take every possible major and most expensive project possible and throw it at them with only a few short years till Go-Live.  Politics, Lack of Standards and Money also had a very large factor in the delays that brought us to where we are.

But the reality is that we are now standing over a pile of parts at 1am on Christmas Eve, with the likelihood that the kids will wake up even earlier than they usually do and won’t be very happy when they unwrap it and it doesn’t work.

Here’s a generic list of what they are looking at. Somewhat in order of what someone else might think their priority should be:

• HIS implementation
• CPOE (eRx)implementation
• EHR implementation
• Point of Care Charting
  • Hardware
    • What endpoint (tablet, laptop, desktop, mobile device)
    • How to get endpoint to bedside (WOW, tablet, wall mount)
    • How to secure endpoint
  • Software
  • Ancillary Devices (scanners, glucometer, spirometer, Dictaphone…..)
• Single Sign-On
• Endpoint Virtualization
• Server Virtualization
• Next Generation Desktop Hardware
• Next Generation desktop OS
  • XPe, CE,  etc.
  • Windows 7 migration
• Point of Care Med Distribution
  • 5 Rights
  • Security
  • Workflow
• Data Aggregation
• PACS storage projects
• General Storage Projects. SAN
• Wireless Implementation
• DR (everywhere else in the world, this means disaster recovery. For HIT, it usually means physician)
• HIE (Health Information Exchange) Planning

And this is a assuming you have other projects already complete like PACS, Billing, Claims Processing, Scheduling, etc. That may be a huge assumption.

The difference between HIT and this hamster is that HIT has a Go-Live (or several).

The sad part is these deadlines are set by people (Presidents, Government, board of directors, CEOs) who have no idea what is involved in making these things work together and are somehow neglecting the fact that everything in the hospital is a mission critical application. It has to work or people could die.

So, how do we organize these? What to do first? How do I avoid mixing race track parts with toy kitchen parts? That is a topic for another day.

But it’s a good thing Santa has beer in the refrigerator.

Explore posts in the same categories: Barriers to eHR, endpoint virtualization, Single Sign-On

Tags: Barriers to EMR, CPOE, EHR, EMR, Health Information Exchange, healthcare IT, HIE, HIMSS, HIS, HIT, hospital implementation, meaningful use, server virtualization, Single Sign-On

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