Author: Mark Egan

Author, Mark Egan works as a business writer and editor in New Jersey. He can be reached at markbegan@mac.com.

Aerial view of Walter Reed National Military Medical Center

Hershey Learns Lessons Building Electronic Medical Records System

At the Department of Obstetrics and Gynecology at Penn State Milton S. Hershey Medical Center, patients and doctors now enjoy the benefits of a system which increasingly uses electronic medical records. But before the current EMR system was developed, administrators at Hershey had to learn a tough lesson – let doctors care for patients and allow technologists to figure out how to design software. When the Obama administration in 2009 authorized billions of dollars in federal stimulus money to help hospitals and doctors with the costs of converting to electronic medical records systems, Dr John Repke embraced the promise of the new digital age. As Chairman of the Department of Obstetrics and Gynecology at Penn State Milton S. Hershey Medical Center and Professor of Ob/Gyn at Penn State College of Medicine, Repke’s challenge was to improve patient care and computerize mountains of paperwork. His department employs 24 doctors, seven advanced-practice nurses and one physician’s assistant. It has five divisions: women’s health (general obstetrics and gynecology), maternal and fetal medicine (high-risk obstetrics), reproductive endocrinology and infertility, gynecological oncology and minimally invasive gynecologic surgery (including urogynecology). Spread over four locations, Repke’s team conduct about 72,000 outpatient visits annually – everything from office visits for something simple like inserting an intrauterine device to more complex matters such as hysteroscopy surgery, endometrial and cervical biopsy procedures and loop electrosurgical excision procedures. They also perform more than 2,000 major gynecological surgeries annually and deliver more than 1,800 babies and have a busy robotics-surgery practice handling everything from infertility to cancer treatments. The department is even part of reality TV folklore as the place Jon and Kate Gosselin had sextuplets in 2004 before becoming the focus of the TLC show “Jon & Kate + 8.” CLEAR VISION Repke and his faculty team had a clear vision for electronic records – to go beyond pieces of paper festooned with the often illegible scribbles of doctors and nurses. They wanted a comprehensive data repository to store all of a patient’s records from her medical history to her lab work and which could handle her many visits throughout a pregnancy. The system would bring records from prenatal care, out patient visits, the delivery and subsequent in-patient stay and records of perinatal care all into one place. As well as making things like accessing records during off-hours and prescribing drugs easier, the new electronic system would also have secondary uses — doctors could harvest data for academic research, for quality reviews or to write reports and papers against. “Physicians saw the power of these electronic records systems and started making them more and more complex, saying we can get this piece of information so let’s include that … because someday in the future we may want to do research on this and we will have all this information available,” Repke said in an interview about that ambitious 2009 effort to transition to EMR. But, Repke now admits, that vision was fatally flawed at the outset. Faculty wanted to use Cerner Corporation’s Millennium PowerChart software which the Hershey hospital system already used. But the software did not have the features they needed so faculty asked Hershey’s developers to build a new interface for it in house. Once built and deployed, the very thing that doctors had pushed for — a comprehensive system with myriad uses — was its undoing. It was simply too complicated, distracting doctors from their patients. TOO MANY MICE CLICKS “For a computer person if you are going to have to click a mouse six times to get to the field where you want to enter your information, it really does not seem like that big of an inconvenience,” Repke said. “But if you are a busy clinician who is seeing 20 or 22 patients in a half day, five days a week, 46 weeks out of the year, suddenly those clicks start to add up to real time and real annoyance.” The doctors had designed the system they had wanted only to realize that they were not user interface or user experience experts. And, they realized, those skills were vital. Hospitals and medical practices across America are rushing to put Electronic Medical Records systems in place to meet a 2015 deadline that demands they show meaningful use of such systems or face fines. Repke’s advice to those about to embark on electronic record projects is to start simple and build additional features later. “We want to build computerized systems that are going to be simple, user friendly and reasonably comprehensive and accurate,” Repke said. “While that seems like it would be easy to do, it is not.” “Our team got bogged down in trying to acquire so much information that it really became unusable,” He said. “We missed the initial mission, which was, ‘Let’s just duplicate electronically the current level that we have on paper and then … we can look at tweaking those systems and expanding them and trying to add other things.” SOCIAL MEDICINE As Vice Chair of the Department of Emergency Medicine and Chief Medical Information Officer at Penn State Hershey Medical Center, Dr Christopher DeFlitch must make sure that doctors and technology work well together. And as co-founder of the university’s Center for Integrated Healthcare Delivery Systems, he studies how technology affects the socialization of medicine, including how electronic records can alter interactions between doctors and patients. DeFlitch said that Hershey’s Ob/Gyn department got better results when they took a different approach to building their electronic medical records system over the past couple of years. Rather than design the system themselves, the second effort saw faculty telling Cerner what they wanted from PowerChart. The doctors explained their workflows and what they wanted from the system and then let Cerner develop a usable interface. “We took a step back and let Cerner work with some of its partners to develop a version of PowerChart that was better for us,” DeFlitch said. The new effort paid off. The department is now almost fully on electronic records for gynecology. Obstetrics now uses a hybrid system with much of a patient’s information available electronically and some records still on paper. Cerner is scheduled to develop new features to complete the transition to electronic records within one to two years. “The ease of the interface is significantly better than it was in the past,” DeFlitch said. “Getting it right took a combination of tool development by the vendor and a deeper understanding of the workflow need of the providers.” “There are experts in each domain. Physicians and nurses are experts in providing care for patients and there are technical experts,” DeFlitch said. “The technology company cannot tell doctors how to take care of patients and the doctor cannot tell the technology company what to build. It is the partnership.” Above all, DeFlitch said doctors must remember that what matters most is people. “Medicine is a social game – people like to talk to other people, whether they are interacting with the record or not,” he said. “So in implementing EMR, if you think the computer is going to do something for you, you are wrong. The computer is just like a stethoscope or any other tool.”

SharkPro Founder Excited About New Apps

SharkPro Software founder and Chief Executive Greg Bailey says the key trend in project management is technology moving to the cloud, enabling  project managers to be freed from endless e-mail chains and helping them develop more effective, collaborative and social workflows. People want to go to the cloud. People are trying to develop more collaborative-based project management workflows which are less formal, more social” said Bailey, whose SharkPro Projects software helps companies make effective use of Microsoft Project. The Houston-based company is releasing apps in January in Microsoft’s Marketplace. SharkPro SharePoint Insite for Project and SharkPro Project View for Project Web App will cost just $29.95 to download. But Bailey believes they are game changers for his fledgling company. “This allows us to sell to international customers without having to actually touch them,” Bailey told MPUG in an interview. “There might be 10 or 20 million users of Microsoft Project out there. There are a lot of users who use Project Desktop that may or may not ever use Project Server. This is a way to make it easier for them to get to that next level to get to Project Server.” A major Wall Street bank, he said, might have 10,000 users of Microsoft Project but only one in 10 might use Project Server.  “We could actually help the rest of those users start to use Project Server easier or start to use Project and SharePoint to collaborate better,” Bailey said. “This dramatically increases our number of potential customers and it gives us a much more globalized presence,” he said. SharkPro has partners in Britain, Germany and Australia and releases its software in English, Spanish, German and Portuguese. It’s clear that Bailey loves his work. He gets excited talking about how the new tools will be used in the workplace, such as a hospital. “The new apps are designed for the Chief Information Officer or somebody walking around with their Windows 8 slate tablet and a doctor comes up and asks what the status of his project is? The CIO can now answer that, real time, right there with his tablet.” Bailey declined to discuss revenues since SharkPro is a private company, but said, “Our growth rate has been astronomical.” SharkPro was recognized as Microsoft’s 2012 Project and Portfolio Management Partner of the Year, just two years after Bailey founded the company to help customers get a faster, more affordable and easier way to interact with Microsoft Project. The company has particularly targeted hospitals, healthcare providers, life sciences concerns and financial services firms by making sure SharkPro has readymade workflows and dashboards that meet their needs. That negates the need to spend hundreds of thousands of dollars having bespoke software configured and is a much quicker way of getting started on Project Server, Bailey said. “We typically are reducing the cost of getting started with Project Server by about two thirds,” he said, adding that customers are up and running on Day 1. The main reason SharkPro Project Server can get up and running so quickly is that as well as being available for on-site installation, it is also hosted in the cloud with customers billed at a rate of $20 per user per month.   Author, Mark Egan works as a business writer and editor in New Jersey. He can be reached at markbegan@mac.com.

Milwaukee Metro Area Gets New MPUG Local Chapter

The Milwaukee Metro area gets its own chapter of MPUG in January thanks to the efforts of Claude Scher of brewer MillerCoors, who hopes to foster a network of local professionals who will share their experiences of working with Microsoft Project. The first meeting is on January 15 from 5:30pm to 8:00pm at Microsoft’s office in Waukesha, Wisconsin. Mindful that local professionals have many special interest groups competing for their attention, Scher said the new MPUG chapter will be productive. “It’s important to have practitioners present along with Microsoft so we don’t just hear how wonderful things are,” said Scher, IT Enterprise Portfolio Manager at MillerCoors. “You want practitioners telling you how painful it was at first when they installed or upgraded their software and that if they had to do it all over again what they would do now having learned those lessons,” he said. “Practitioners are who you want speaking at these meetings because their pain is my pain.” Scher attended a Microsoft Project conference in March in Phoenix, hoping to connect with others who had followed a similar path. There, he met MPUG representatives at the national level and decided to launch a local chapter Scher, a French native who has worked in Milwaukee for more than 15 years, enlisted Danny Smith, Deputy Chief Information Officer at Marquette University, and Skip Wick, an IT project manager at Rockwell Automation, to drum up interest in the new chapter. “We certainly have enough momentum to start and, once we get up and running, we want to grow the community,” he said, noting that many local employers use Microsoft Project and are interested in networking. The closest MPUG chapters are Chicago or Madison, both more than 60 miles away. Scher said January’s meeting will focus on the benefits of Microsoft Project Server 2013 and also on what MPUG offers members. Scher expects three types of people at the new chapter: Professionals who do not use Microsoft Project but are thinking of using it. Project managers using an old version of Microsoft Project who want to find out the benefits and challenges of an upgrade. Experts who love Microsoft Project, who like to give presentations and want to share. “In IT, the challenge is often that our tools have such incredible functionality that you often only use 10 or 20 percent of what the software can do,” Scher said. “Learning how to really use that functionality is a great way to maximize your investment and your productivity.” Scher, who is also a board member of the Project Management Institute’s Milwaukee chapter, said Microsoft Project is typically used in three ways, for project management, finance management and resource management. He said using the software for all three purposes can eliminate redundancies. He said  a big challenge in Project and Program managers’ work is portfolio optimization — deciding how to prioritize among the hundreds of projects that are competing for scarce resources. Scher has worked for companies including Kohler, GE Healthcare and Johnson Controls. Asked what his dream project would be, he said he was captivated by a presentation at a recent The Project Management Institute (PMI)® meeting on upgrading federal highways in Milwaukee. “There are so many moving parts and so many details to capture from thousands of contractors and workers, it seems like really exciting work,” he said.   Author, Mark Egan works as a business writer and editor in New Jersey. He can be reached at markbegan@mac.com.