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New INFRAM Model Creates Healthcare Infrastructure Benchmarks

Posted on November 14, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

During the frenzy that was healthcare organizations rushing to implement EHRs and chase government money, it was amazing to see so many other projects get left behind. One of the biggest areas that got left behind was investments in IT infrastructure. All the budget was going to the EHR and so the infrastructure budgets often got cut. There were some exceptions where upgrades to infrastructure were needed to make the EHR work, but most organizations I know chose to limp along with their current infrastructure and used that money to pay for the EHR.

Given this background, I was quite intrigued by the recent announcement of HIMSS Analytic’s INFRAM (Infrastructure Adoption Model). This new model focuses on a healthcare organization’s infrastructure and whether it’s stable, manageable, and extensible. I like this idea since it’s part of the practical innovation we talk about in our IT Dev Ops category at the EXPO.health Conference. What we’ve found is that many healthcare organizations are looking for infrastructure innovations and the benefits are great.

The INFRAM model has 5 main focus areas:

  • Mobility
  • Security
  • Collaboration
  • Transport
  • Data Center

No doubt these are all areas of concern for any healthcare CIO. Although, I wonder if having all 5 of these in the same model is really the best choice. A healthcare organization might be at a level 6 for secruity, but only at a level 3 for mobility. Maybe that’s just fine for that organization. I guess at the core of this question is whether all of the capabilities of stage 7 are capabilities that are universally needed by all healthcare organizations.

I’m not sure the answer to this, but I think a case can be made that some organizations shouldn’t spend their limited resources to reach stage 7 of the INFRAM benchmark (or even stage 5 for some organizations). If a healthcare organization makes that a priority, it will probably force some purchases that aren’t really needed by the organization. That’s not a great model. If the above 5 focus areas had their own adoption models, then it would avoid some of these issues.

Much like the EMRAM model, the INFRAM model has 7 stages as follows:

STAGE 7
Adaptive And Flexible Network Control With Software Defined Networking; Home-Based Tele-Monitoring; Internet/TV On Demand

STAGE 6
Software Defined Network Automated Validation Of Experience; On-Premise Enterprise/Hybrid Cloud Application And Infrastructure Automation

STAGE 5
Video On Mobile Devices; Location-Based Messaging; Firewall With Advanced Malware Protection; Real-Time Scanning Of Hyperlinks In Email Messages

STAGE 4
Multiparty Video Capabilities; Wireless Coverage Throughout Most Premises; Active/Active High Availability; Remote Access VPN

STAGE 3
Advanced Intrusion Prevention System; Rack/Tower/Blade Server-Based Compute Architecture; End-To-End QoS; Defined Public And Private Cloud Strategy

STAGE 2
Intrusion Detection/Prevention; Informal Security Policy; Disparate Systems Centrally Managed By Multiple Network Management Systems

STAGE 1
Static Network Configurations; Fixed Switch Platform; Active/Standby Failover; LWAP-Only Single Wireless Controller; Ad-Hoc Local Storage Networking; No Data Center Automation

STAGE0
No VPN, Intrusion Detection/Prevention, Security Policy, Data Center Or Compute Architecture

As this new model was announced, I had a chance to talk with Marlon Harvey, Industry Solutions Group Healthcare Architect at Cisco, about the INFRAM model. It was interesting to hear the genesis of the model starting first as an infrastructure maturity model at Cisco and then evolving into the INFRAM model described above. Marlon shared that there had been about 21-24 assessments and 35 organizations involved in developing this maturity model. So, the model is still new, but has had some real world testing by organizations.

I do have some concern about the deep involvement from vendor companies in this model. On the one hand, they have a ton of expertise and experience in what’s out there and what’s possible. On the other hand, they’re definitely interested in pushing out more infrastructure sales. No doubt, HIMSS Analytics is in a challenging position to balance all of this.

That said, a healthcare CIO doesn’t have to be beholden to any model. They can use the model where it applies and leave it behind where it doesn’t. Sure, I love having models like INFRAM and EMRAM to create a goal and a framework for a healthcare organization. There’s real value in having goals and associated recognition as a way to bring a healthcare IT organization together. Plus, benchmarks like these are also beneficial to a CIO trying to convince their board to spend more money on needed infrastructure. So, there’s no doubt some value in good benchmarking and recognition for high achievement. I’ll be interested to see as more CIOs dive into the details if they find that INFRAM is focused on the things they really need to move their organization forward from an infrastructure perspective.

The State of the Healthcare CIO

Posted on November 2, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I’ve talked to hundreds of healthcare CIOs this week at the CHIME Fall Forum, a number of themes keep coming up. No doubt there’s always a lot of excitement in the air at a conference like this. In many ways, it’s great that there’s a good, optimistic energy at a conference. A conference wouldn’t be very good without that energy, but under the covers, there’s often more to the story. Here are some broad insights into the state of the healthcare CIO that goes beyond the natural excitement and energy of a conference.

No More Systems – Most of the CIOs who I’ve talked to feel like they have all the IT systems they need. In fact, most are trying to find ways to get rid of IT systems. They’re not looking to add any more IT systems to their mix. There’s a strong desire to simplify their current setup and to maximize the benefits their current IT systems. They don’t want to add new ones.

Do Want Solutions – While healthcare CIOs don’t want to add new systems, they do want to find solutions that will be complementary to their existing systems. There is a massive desire to optimize what they’re doing and show value from their current IT systems. Solutions that are proven and work on top of their existing infrastructure are welcomed by these CIOs.

Security Is Still a Concern – I have a feeling that this topic may never die. Security is still a huge concern for CIOs and something that will continue to be important for a long time to come. Most now have some kind of security strategy in place, but I haven’t met anyone that’s totally comfortable with their security strategy. It seems that this is what keeps CIOs up at night more than any other issue.

Analytics Is a Challenge – Most of the healthcare CIOs know that analytics is going to be an important part of their future. They can see the potential value that analytics can provide, but most don’t know where to find these analytics. Most organizations don’t have a clear analytics strategy or direction. We’re still just seeing anecdotal results for very specific solutions. There’s no clear direction that every healthcare CIO is following for analytics.

CIOs are Stressed – It was very appropriate that yesterday’s keynote presentation was on turning stress into a positive. Most of the healthcare CIOs I met are quite stressed. They have a lot on their plates and most don’t know how they’re going to manage it all. Plus, they’re still overwhelmed by all the changing regulations and reimbursement changes. The fact that there doesn’t seem to be any end in sight adds to that stress.

Turnover is Still High – It seems that there’s still a lot of turnover that’s happening with CIOs. This is a challenge when it comes to continuity at organizations. However, those CIOs that have been able to stay at an organization for a longer period of time are starting to see new opportunities to be more strategic. They’ve fought all the initial fires and cleaned up the processes and now they can start working on more strategic initiatives.

Holding On vs Embracing Change – I see two different views evolving by CIOs. Many are holding on tightly to the old Chief Infrastructure Officer versus embracing the new Chief Innovation Officer mindset. CHIME is certainly espousing the view of the CIO becoming a Chief Innovation Officer and it’s the view that I think is best as well. However, there are plenty of CIOs that just want to provide the technology to their organization. It will be interesting to see what happens to both of these approaches to the CIO position.

Those are some high-level thoughts from talking with CIOs at the CHIME Fall Forum. What are you seeing? Are you seeing or hearing anything different from what I described above? We’d love to hear your thoughts in the comments.

Healthcare CIO Mindmap

Posted on April 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

During HIMSS, Citius Tech put out this great image they called the Healthcare CIO Mindmap. It’s a beautiful display of everything that’s happening in healthcare IT. Although, it’s also an illustration of the challenge we and hospital CIOs face. Is it any wonder that so many hospital CIOs feel overwhelmed?

Enjoy the Healthcare CIO Mindmap in all its glory below (Hint: Click on the image to see the full graphic):
Healthcare CIO Mindmap

I think that image is enough for anyone to chew on for one day. I’d love to hear your thoughts on it.

Live from CHIME 2013

Posted on October 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week we’re broadcasting live from CHIME 2013. Anne Zieger will interview John Lynn who’s attending the CHIME 2013 Fall CIO Forum. We’ll discuss what’s being discussed at the top healthcare CIO conference. The live stream begins at 10 AM PST (1 PM EST) on October 10, 2013 and the recorded version will be here after the event.

Top Considerations for Transitioning to ICD-10 – Guest Post

Posted on August 30, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Chuck Podesta is Fletcher Allen Health Care’s chief information officer.

ICD-10 would not be so daunting if the deadline was not occurring during the rush to get EHRs for meaningful use. Add in value-based purchasing, bundled payments and transitioning to ACOs, and you can see why many CIOs are retiring early or migrating to the vendor or consulting world. We are just over two years away from the October 2013 deadline, and there is much work to be done. ICD-10 contains 68,000 codes, as opposed to the 13,000 currently used in the ICD-9 world. There is a code for every condition that exists on the planet.

The revenue cycle system, which includes registration, HIM and billing/AR, will be the lynch pin to ICD-10 readiness. Having a solid vendor partner and a strong product is key to a successful transition. Many solution providers – like GE Healthcare, who recently launched the 5.0 version of their Centricity Business product – are updating their systems to better comply with ICD-10. GE Healthcare also allows existing Centricity Business customers to retrofit the new ICD-10 functions to the 4.6 version of the product. Strong vendor partners take the burden off you by being ahead of the game and delivering the appropriate technology in time so you are not racing to the finish line.

By now, you should have at least a steering committee in place. Your IT shop should have completed an inventory of all applications that are impacted by ICD-10, including reporting systems. You will be surprised by the number of applications, even if you have taken the one-vendor approach for most of your IT needs. You will need to contact all affected application vendors to see what the plans are for ICD-10 compliance. Most likely, upgrades will be required that will need to be scheduled.

Training of coders will be critical, along with implementing clinical documentation improvement programs. Documentation improvement programs are difficult to implement and will be viewed by providers as more work on top of an already busy schedule. New technologies such as computer-assisted coding will definitely help, but success will be a combination of process improvements and technology.

Lastly, remember that the deadline is for Medicare and Medicaid patients only. Unless the rest of the payer industry follows the same deadline (highly unlikely), you will need to run both ICD-9 and ICD-10 systems.