Building Unity Farm - Adopting Alpaca

Memorial Day weekend was a busy time at Unity Farm - spending time with our newly adopted alpaca, doing woodland/forestry management, and inoculating mushroom logs.How did we adopt new alpaca?In an unusual chain of events,  a leading alpaca breeder in Maine was the former editor of a healthcare IT magazine and knows me well.   When she heard about a family in Massachusetts trying to place their three alpaca, she recommended Kathy...[Readmore]

Clinical IT Governance Update

Yesterday I led the Clinical IT Governance meeting at BIDMC and I thought it would be interesting for my readers to get an inside look of the kind of topics we're discussing and how we're implementing our most challenging projects.1.  Joint Commission debriefLast week the Joint Commission visited BIDMC and the experience was very positive.  When there are process variations and potential shortcomings identified by the Joint Commission,...[Readmore]

HISP to HISP communications

As Massachusetts works through the details of building a trust fabric for health information exchange, we have been working through another set of challenges in HISP to HISP communication. Meaningful use Stage 2 requires EHRs to support the Direct Project implementation guide, which uses SMTP/SMIME as a transport protocol.   Optionally, Stage 2 also supports XDR/SOAP.In the world of standards, "OR" always means  "AND" for implementers....[Readmore]

Building Unity Farm - The Bees Arrive

On Saturday night 96,000 Italian bees arrived at Unity Farm in 8 hives.   What are Italian bees?   Here is an overview of bee types.There are many subspecies of the honeybee, Apis mellifera.  Each has different characteristics in temperament, honey production, winter hardiness, swarming behavior, and disease resistance.    We chose Italians that had overwintered in Massachusetts for their lack of aggressiveness, consistent...[Readmore]

Documenting End of Life Care Preferences

Following up on yesterday's post about ICU dashboards, I think it is equally important to document end of life care preferences in the electronic health record.   The HIT Standards Committee has been charged in 2013 with developing the standards for structured data capture of end of life care preferences.At BIDMC, we've already designed an approach in conjunction with the Institute for Healthcare Improvement's Conversation Ready project.Conversation...[Readmore]

Patient and Family Engagement in ICUs

My father died 2 months ago and now with a bit of distance from that emotional event, it's time to further reflect on technology to support patients and families in ICUs. BIDMC has been speaking with a major foundation about creating a cross-disciplinary, multi-institutional, open source application to turn critical care data into wisdom for patients and families.How might it work?  Let me use my father as an example.My father had multiple sclerosis...[Readmore]

Building Unity Farm - The Mushroom Farm Begins

Last weekend, my wife Kathy, Bill Gillis (CIO of the Beth Israel Deaconess Care Organization), and I completed 72 Oyster mushroom totems and 60 Shitake logs - about 10,000 pounds of wood requiring 3000 individual inoculations.Here's how we did it.I cut 72 two foot segments of poplar, 8 to 16 inches in diameter, from the trees we felled behind the house in the early spring when sap was flowing but leaves had not yet emerged.   This wood...[Readmore]

Personal Health Record Use by Adolescents

In response to many questions about PHR use by adolescents, I asked Fabienne Bourgeois, the expert at Children's Hospital Boston, to write this guest blog post -As more and more practices and hospitals are making patient portals available to their patients, providers of adolescent patients are encountering a major hurdle: how to handle confidential adolescent information.While adult patients generally maintain full personal control...[Readmore]

Building a Trust Fabric in Massachusetts

Yesterday, several Massachusetts HIE stakeholders discussed how best to create a trust fabric among the array of vendors, organizations, and regional subnetworks that will exchange transfer of care summaries using the Meaningful Use Stage 2 standards.    Here's the presentation we used to facilitate our discussion.Initially our state HIE, the MassHIWay, presumed it would be the certificate authority/registration authority for all state...[Readmore]

Building Unity Farm - Shearing the Alpaca

Last weekend we sheared the alpacas and llama.  As Unity Farm works to become a self sustaining agricultural entity,   we plan to sell natural colored alpaca yarn and hand made raw fiber cat toys this Summer.Above, you'll find the before and after photos.    Our enormous and fluffy animals now look like creatures from a Dr. Seuss book.Here's how the day went.We sheared from 12:30pm-9:30pm, with a few small breaks.  We...[Readmore]

The May Massachusetts HIT Council Meeting

Just as the national HIT Standards Committee meets every month and I record its deliberations on my blog, the Massachusetts HIT Council, a governance body for healthcare IT activities in the Commonwealth, meets monthly.   The Council is a multi-stakeholder body including public and private sector participants from every aspects of the healthcare system.We met on Monday to review progress on State HIE implementation.   Here are the presentation...[Readmore]