Friday, February 25, 2011

RFI: Enterprise Health Information Systems Project

The Cayman Islands National Health System is soliciting vendor partners for participation in the Enterprise Healthcare Information Systems Project. At present, the core enterprise applications are provided by the Cerner Corporation. The contract for those services expires in June 2013. This RFI begins a re-compete process for the award of that contract. The intent is to evaluate other vendors and products, and determine if it is in the best interests of the Cayman Islands to remain in partnership with Cerner. Cerner will be invited to participate in this re-compete.

You can download the RFI at:  Request for Information (RFI)

Wednesday, February 23, 2011

Healthcare Transformation = Sustainable Business Models x Electronic Medical Records

The Cayman Islands are unique in many aspects, but among them is the size of the nation compared to the sophistication of the business and government processes.  With a population of only 50,000 people, they are roughly the same size as a rural community in the United States-- ranked 201st on the size of countries by population.  But the C.I. government's processes and business acumen are far more advanced than their size would lead some to believe.  Their history of financial management skills-- the Islands manage $1.5T (as in trillion) in assets- is underwritten by a culture that is forward thinking and embraces risk.   The relatively small size of the population supports an agile government process that can move quickly to react to changing cultural and economic issues.  It is worth noting that there is no income tax in the Cayman Islands-- one of only 6 countries in the world with that tax model and those other countries are dominated by oil-producing economies.  Without any substantial exports, the Cayman Islands' society has managed to prosper for over 200 years on this model, including the provision of an impressive healthcare service.  I'm convinced that the tax model and the healthcare system are applicable to any nation, regardless of size... in fact, in larger countries like the U.S. where imports and exports are a substantial part of the economy, the tax model and healthcare operational model would function even better.

The healthcare system in the C.I. is already advanced by U.S. standards.  Health insurance, like car insurance, is required by law, so everyone is  managed in a defined risk pool.  A national insurance corporation and healthcare system provide all levels of care for approximately 70% of the country, the remainder provided by private practice and payers, so choice is accommodated, but care is ensured.  In November, the Cayman Islands Ministry of Health sponsored an international conference on healthcare reform, with the intent of further defining an already existing path of change towards a high quality, economically sustainable healthcare system for the nation.  Here's a link to the speakers:  Healthcare 2020 Conference.  I presented a lecture about the role of information technology and electronic medical records in healthcare transformation, but I also spent a good deal of time talking about fundamental business models and motives because technology alone is simply white wash on a dirty fence.  Here's a link to those slides:  Role of Technology in Healthcare Reform.

The essence of the message is simple:

Healthcare Transformation = Sustainable Business Models x Electronic Medical Records

While we are all enamored by the HIMSS conference, Meaningful Use, and HITECH, if we-- the U.S.-- don't address fundamental and sustainable economic models with as much enthusiasm as we have the technology, Transformation will fall far short.  We are, at present, adopting technology which is largely based on old economic models.  The speed of economic reform, primarily reimbursement models, must exceed the speed of technology adoption in healthcare.

Contrary to popular anthropological belief, we are not Homo Sapiens.  We are Homo Economicus and our behaviors are primarily driven by our desire to gain additional wealth, and usually at the expense of others.

Change the economic model and you change the behavior, regardless of what you do with technology.


Saturday, February 19, 2011

Selfless Service and Batting Averages

Serving other people and causes in a way that boosts their success, esteem and fulfillment in life is like playing baseball. About two-thirds of the time, maybe a little less, those same people and causes will forget or criticize you for what you didn't do for them, rather than remember or thank you for what you did. That's a fairly typical batting average for human nature.

Anything above .300 is pretty good.  :-)

Nuclear and Healthcare Decision Making

Nuclear warfare operations was my data-driven decision making environment before the healthcare phase of my career. It was all about recogni...