This a great interview with both the vocal and the transcripted text at Anthony Guerra’s Blog,  If you are in Healthcare IT and/or research and write about it, the truth comes out here.  I attend a few conferences and conventions and what Anthony reports here from Dr. Halamka is true.  You can just enter industry related conversations (which is some of what I have done) and if you read people and see the struggles in preparing the “best” answer of the day with their responses, it’s all there.  Back in December of 2010, I attended this conference and spoke to some big hospital and other healthcare CIOS and the stress was as plain as day with trying to do everything that is one their plate with meeting deadlines and these were some of the most brilliant and fast working CIOs around.  Actually it was probably a nice break to attend a conference. 

CIO Confidence In Meaningful Use Drops-The New Left Curve of Technology That Arrives Daily Contributes-Don’t Burn These Folks Out

Here’s another past post at the Quack on the same subject. 

Meaningful Use-Money And Data Being Thrown Every Which Way To See What Sticks With Limited Expertise And Not Enough Time at the Top to Lead a Full Debugging Process

Sometimes you have to get out in the real world and get a taste of what’s going on outside the internet and you can’t absolutely embrace everything as it comes down the tubes with the projected due dates, it just can’t work.  The paragraph below from the interview with Dr. Halamka sums it up perfectly.

“It’s just that as I survey the country, CIOs are overwhelmed and Meaningful Use has taken the bulk of their attention, along with lots of new compliance issues. So, when you say, “Well, where are you on the ICD-10 project?” they’ll say, “Oh my god, you know, we haven’t started. We aren’t really planning. We just can’t find the resources to do it.”image

I just had this conversation with someone in the financial area a few days ago reiterating how healthcare CIOs are burning out.  When you listen to Dr. Halamka talk about his time and how he allots it, he’s lucky he doesn’t need a lot of sleep.  I like the talk too about ACOs, “everyone doesn’t know what it is, but they want to be one”, and that is the truth as about as bluntly and accurately as you can get, reality.  Back on the CIO topic we don’t know for sure but it’s probably a good bet we burned out the US CIO too.  I have some correspondence with a few CIOs too  and they are all maxed out and it’s becoming a very “thankless” job just due to the fact that not many understand what falls their wings these days with technology. 

Vivek Kundra-US CIO To Resign And Take Fellowship at Harvard-Was He OverTaxed And Burnt Out, If So That is Allowed Today As This A True Reality for CIOs All Over the US

The“back door deals” that happen outside the knowledge or consulting of the CIO is beginning to happen more frequently and without a CIO that ties imageeverything together, companies end up spending tons more than needed and sometimes areas of security are left untied, so the CIO needs to be included and consulted with and not to the point of burning them out either, and I am starting to see some of that with complicated IT infrastructures. 

In addition, public CIOs are also feeling the heat too with Medicaid and a while back I asked if this bubble was going to break as insurers bring down what they pay doctors and hospitals, and yet the Health IT expense side keeps getting bigger with aggregating and adding new algorithms to software, and of course those all needs standards and so forth. 

Healthcare Reform Putting Additional Pressure on Public and Medicaid CIOs-The Health IT Bubble Gets Closer As Money And Digital Literacy is Scarce

The health IT side is getting more time consuming and costly and that’s why the insurers are buying up IT companies, for the money, but the customers who ultimately pay (doctors and hospitals) for Health IT software and services have shrinking incomes.

How is this going to work when doctors and hospitals can't afford it and the Health IT expense as it goes beyond stimulus bonuses?  In the interview Dr. Halamka says you just cut back and do less, no choice.  He also states like I have said to, slow down. I approach it a lot from the consumer software that is such a glut out there, stop writing mHealth apps that do one thing and work together and collaborate and stop tossing software out there that few or nobody uses, after all someone gets paid to write it and the odds are pretty good that the people who create the gluts of software, never use it themselves.  Recently I saw HHS with a bee in their bonnet with a Facebook software contest, give me a break.  image

You know you just cannot jump on every tidbit of technology that jumps out there today and have to be wise to determine if it is for you along with a ton of other items to look at and think if you do this as a consumer, just imagine what the CIO does and all the responsibility that goes along with it. 

This is very much worth listening too and Dr. Halamka stresses “engineer for the little guy”.  Anthony says this is Chapter one so I’ll be sure to tune in for Chapter Two when it comes out as well.  BD 

… you look at the complexity, the regulations, the compliance, the infrastructure, the cloud, the mobile devices, et cetera. And boy, 2011 represents a different world for CIOs than it was 10 years ago.

If you think about being a healthcare CIO right now, you have the 5010 deadlines (Jan. 1, 2012), ICD 10 (Oct. 1, 2013), you have Meaningful Use Stages, 1, 2, and 3, you’ve got a swirl of compliance and privacy issues, and then you have healthcare reform. It’s not as if all of this is happening tomorrow, but it is certainly happening in the next 24 months. And so, yes, I better have some increased flexibility in that next 24 months to deal with these challenges.

The question will be what is the scope of Stage Two? And that’s where there may be some controversy because, as you look at some of the proposals around the level of patient and family engagement, it’s all extraordinarily forward looking, good stuff, it’s just how much can you do and how fast.

I really believe that, at the moment, there is too much change, too fast, and ICD-10 is the straw that breaks the camel’s back.

Resources, well, all we have to do is pick up the paper today and I hope your stock market portfolio is doing okay (laughing). But from 2008 to the present the economy has not been so robust. So wage growth and position growth has been pretty limited.

So, if time is fast and resources are scant, your only choice is to reduce scope. And so, we really have to deal with governance bodies, ask what are our highest priorities and what can we do well and what should we not do. And hence, the reason why I’ve said, “Let’s temper the amount of work we’re doing.”

So, I actually have direct reports at community hospitals who I have to help achieve Meaningful Use. And so, I actually live the community hospital experience every day