Scott, you just participated in one of the biggest Epic go-lives ever. What are you going to do now?
I went to Berlin.
Last month, my wife and I traveled to Berlin – I had a HIMSS Board meeting there and we decided to make a vacation out of it (thanks to Gram MacLean for watching the kids for a week). I’m at the tail end of the baby boom generation and my Dad was a WWII veteran. For most of my life, it felt like the Cold War was the normal, and the Iron Curtain was permanent. Last month, I had the chance to learn more about this history and to see how Berliners have dealt with the Berliner Mauer (Berlin Wall, up for 29 years, has been down for 25 now). These cobblestones and plaques (below top) mark the location of the wall throughout the city. In the middle, I’m standing in front of the largest remnant of the wall where artists were commissioned to paint murals as a memorial to that chapter of history. Have no fear, there was easy access through the wall 100 yards to the right. I was pleasantly surprised to learn the perspective that this was a relatively short period of history and that Berliners are enjoying a unified and vibrant city today. On the bottom, I’m standing in front of the Brandenburg Gate on what was the western side (the wall would have been right behind me). The guidebook described the city skyline as a “canopy of cranes,” and indeed, there is a remarkable amount of construction going on. As you probably know, Germany is a strong economic contributor to the EU and it certainly appears that they have a lot of money for development.
The HIMSS Board meeting went well. As you may know, HIMSS’ mission states that it’s a global, cause-based, not-for-profit organization focused on better health through information technology. HIMSS leads efforts to optimize health engagements and care outcomes using information technology. Throughout the last five years that I’ve served on various HIMSS Boards, the organization has grown its reach through education and conferences, analytics, media and personal connected health – and, as you might expect, the largest opportunities have been outside the US. It’s been interesting to see that regardless of the culture or payment system, everyone has the same issues – the need to improve outcomes at lower costs. IT is seen as an enabler of those goals across the world. I think HIMSS has done a good job pursuing this mission and it’s been a privilege to be part of the governance as we have structured it to serve this expanded global mission.
There is much to be said about our Partners eCare Program (Epic implementation) and I’ll leave that to our Chief Clinical Officer and the many people who are leading and working on the project. My teams had the privilege of working on the design, build and operation of several of the infrastructure technologies including network, Unix and Windows servers, storage, Citrix and printers/workstations. We are fortunate to have very talented people and the capital to have high availability and disaster recovery configurations. Still, the size and scale of our EHR instance makes us particularly diligent as we add concurrent users. The group of hospitals that went live at the end of May was one of the bigger Epic go-lives and we have been very pleased with the performance of the infrastructure.
CIOs will realize that projects like this aren’t the only challenge. IT staff and processes get squeezed even more during these times as systems and infrastructure are added before old systems are decommissioned. In some cases, temporary integration needs to be developed and there is conversion work that causes peaks in CPU utilization and storage arrays. Like everyone, we are also under pressure to be reducing unit costs and operate more efficiently. Given all of these parameters, I think it’s safe to say that our teams have worked about as hard as they ever have.
Perhaps the best indicator of the last month is the graph below from my Fitbit. It shows my resting heart rate for the last 30 days. The peak at 72 was during the go-live and the precipitous drop to 61 represents my vacation where I unplugged and didn’t read email. Sadly, the rise again at the end shows when I re-engaged with email and the issues we are all trying to solve. I take solace in two things from this – 72 isn’t the worst resting heartrate and at least I know I can relax if I try.
The Command Center for the go-live was hosted at Dana-Farber Cancer Institute. It was an unexpected pleasure to see and catch up with so many colleagues from Dana-Farber and Brigham and Women’s. I had spent almost 10 years working there and built good relationships that I just haven’t been able to keep up with during my time at Newton-Wellesley Hospital and in my current role. It was heartening to be counted as a Dana-Farber “alum” and to reflect on all of the information systems progress over the past 20 years there.
Sometimes it may feel challenging to move things forward in healthcare IT, but these Partners and HIMSS milestones are a time for me to stop and remember that what we do does make a big difference for our patients, caregivers and the entire community.