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In addition to increasing our efficiency, maximizing our reimbursement, making our records legible, decreasing the cost of care, and other assorted miracle cures, HIT adoption is being promoted as an excellent way to increase patient safety. Unfortunately, there is little proof that current EMR technology accomplishes this goal. Several recent studies have shown little to no improvement in outcomes with increasing use of HIT.

In fact, several studies have shown that healthcare systems more reliant on HIT were less likely to comply with treatment guidelines than those that were less reliant. In one pay for performance (P4P) pilot program of healthcare systems using EMRs, only eight out of ten were able to earn any P4P bonus at all, and the bonuses earned were not enough to cover the cost of technology that had to be purchased to allow the data mining needed to participate in the program. Multiple healthcare systems that incorporated EMRs with clinical decision support have reported that providers often disable the clinical support “alarm” pop-ups, because they find them to be distracting, impeding and slowing up work flow. In my opinion, EMR in its current state does not seem to offer much of a solution to the problem of needing to increase patient safety.

Another approach to increasing patient safety involves adopting the techniques developed and used by the airline industry since the 1990s. Those techniques were designed to address the problem of rising accident rates that began to occur as a result of the increasing speed and complexity of the equipment and the increased traffic that accompanied the full adoption of jet aircraft. Healthcare has also become much more complex, with greater workloads for providers—leading to increased adverse events for patients. In light of this, some experts have theorized that healthcare may be amenable to some of the same safety measures taken by the aviation industry. The aviation approach involved accepting that pilots alone cannot solve all safety problems, turning instead to building a team approach to safety. The team approach involves training the entire flight team (pilots, co-pilots, navigators, flight attendants, ground crew, etc.) to be aware of safety goals and that each team member has an important role in ensuring they are met for each flight.

Safety training goals focus on not only specific safety issues, but also on the importance of increased communication about safety concerns; rapid team building when crews are flying together for the first time; extensive pre-flight team preparation; and setting goals, roles, and expectations as a team. I am concerned that all of this may not translate well to healthcare. Pilots usually fly one type of airplane and undergo extensive training on that specific equipment. Also, they tend to be very attentive to safety concerns, because they are in the same plane as the passengers. As the saying goes, “the pilot is always fi rst to the site of any aviation accident.”

Although a team “huddle” might be helpful at the start of every day in the clinic, one has to wonder just how helpful discussion of anticipated problems will be given that the list of patients to be seen often changes throughout the day. Plus, at least 50% of the time, the problem a patient tells the scheduler they are coming for isn’t what they actually end up being seen for. How can a team of providers prepare for that? I do like one aspect of the aviation safety program: pilots are forbidden to fly more than 30 hours per week or 100 hours per month. I think fatigue plays a major part in healthcare errors. However, I do not see rules enforcing workload limits ever being adopted in healthcare due to the cost of replacing all of those hours off for rest and training with additional physicians who will provide the care those well-rested physicians used to provide.

In the end, I think all of us in the healthcare industry must hope for EMRs with usable clinical support systems that enhance both patient care and safety without slowing down the process of providing that care. This does not appear to be available yet.

Everest “Tad” Whited, MD, PhD, is a board-certified family practitioner with a solo practice in Pflugerville, TX

Articles

In addition to increasing our efficiency, maximizing our reimbursement, making our records legible, decreasing the cost of care, and other assorted miracle cures, HIT adoption is being promoted as...

Patient Safety and HIT: Adopting Aviation Guidelines?

Many of my colleagues use tablet PCs and handheld computers. I won’t deny that these gadgets are cool, but I have to wonder if it really makes sense to use them in everyday practice.

Handhelds are relatively limited in their functionality—they have small screens, aren’t compatible with most peripherals, and run a limited number of programs. Most doctors I know use their handheld as a cell phone and/or e-mail device (eg, Blackberry, iPhone), to run clinical reference and decision-support programs (eg, Epocrates), or to write electronic prescriptions.

Although some PDA screens go up to four inches diagonally, most sport a 2.5-inch screen, which is far too small to easily view and manipulate most medical information. Tablet PCs are a middle step between handhelds and traditional laptop and desktop computers. Currently, most tablets run Microsoft Windows XP Tablet PC Edition as their operating system. In the most common configuration, a tablet PC looks like a normal laptop computer but usually has a swivel screen that can rotate 180 degrees and lay flat over the keyboard. In place of a simple touch screen, which could register false entries from a stray finger or sleeve, most tablet PCs require a stylus for entering data; selecting, dragging/dropping, and opening files; drawing diagrams; and writing notes. Windows XP Tablet PC is fairly good at translating handwriting to text, in theory allowing users to “scribble” notes that are automatically translated into typed text within an application (such as an EHR). Although Tablet PC handwriting recognition software “learns” as it goes and becomes more accurate over time, in practice, even a low mistake rate in translating your handwriting to typed text means multiple taps and clicks to fi x erroneous text—requiring even more time to create a record. Despite this serious issue, it is estimated that 25% of EHR users rely on this method to enter data into their records.

Although tablets are cool, the handwriting recognition issue and the need for multiple taps to document a simple note make these systems rather cumbersome. As we all know, most patient histories and thoughtful assessments are not that amenable to the checkbox approach to documenting (see “

10 Secrets EHR Vendors Don’t Want You to Know

”). Entering the patient’s story into an EHR often requires a more robust entry system, such as typing or speech; otherwise you end up with a note that looks like you just completed taking a Yes/No inventory. In my experience, it is hard to beat the speed and accuracy of a keyboard for adding notes to a chart and moving from field to field in a form. For non-typists, current speech recognition programs, such as 

, are significantly more accurate than they have been in the past, providing an efficient solution to documenting the dozens of notes physicians strive to complete each day.

The other major problem with using tablets in your practice is their reliance on a wireless network. Although they can be plugged into a hard-wired port in each exam room, doing so negates the tablet’s portability benefi ts due to the significant wait time required while the tablet negotiates and connects to the hard-wired connection. Not plugging in at each station, however, leaves you at the mercy of your wireless network. Even worse, in terms of privacy and HIPAA concerns, ensuring consistent and strong encryption over the wireless network results in further delays.

These relatively short delays (slower data exchange, increased time to fix incorrectly translated handwriting, multiple clicks and screen navigation to get around a note, etc) add up, and before long, you’ll realize that using the “cool” equipment may make each patient encounter longer, resulting in decreased patient volume and revenue.

Despite all the cool features and portability benefi ts of handhelds and tablets, I still believe that putting an inexpensive desktop computer in each exam room remains the optimal choice.

Dr. Bertman is Physician Editor-in-Chief of 

. He is also a Clinical Assistant Professor of Family Medicine at Brown University and president of 

, a leading developer of Electronic Health Record (EHR) software. He also is the founder and president of 

, a consumer website focusing on personal medical topics. He is in private practice in Hope Valley, RI

Many of my colleagues use tablet PCs and handheld computers. I won't deny that these gadgets are cool, but I have to wonder if it really makes sense to use them in everyday practice.

Are Cool Handhelds and Tablets the Right Choice for Your Patients?

It would be impossible to overstate the importance of backing up your practice data. This is especially true in this era of electronic medical records (EMRs). In fact, the 

 requires that covered entities have a written contingency plan for responding to system emergencies, including a detailed plan concerning the data back-up and recovery process in the event of a disaster. In Louisiana, the implications of this policy became abundantly clear after Hurricane Katrina with the irretrievable loss of critical practice and research data. Your hard drive is going to crash; it is simply a question of when.

Fortunately there are several options for automating the data backup process; some charge a modest annual fee, but some are available at no cost. You should first familiarize yourself with the following terms:

• Full Back-up — includes all data files and system settings for your computer. These do not include your operating system or program files. If you want to do a full (or “bare metal”) backup, you’ll need to use a program that makes a duplicate “image” of your computer. 

 provides this functionality, or you can use software such as 

• Differential Back-up — backs up only those files that have changed since the last full back-up. This makes for a rapid back-up process, but also makes a system restore much more tedious because the full back-up and each incremental back-up must be individually restored; this would save each follow-up visit individually after the initial history and physical.

• Incremental Back-up — backs up all changes since the last back-up of any kind. Thus, a restore operation would only need the full and the latest incremental.

Where should the back-up be stored? Of course, you should avoid recording the back-up on the same hard drive as the original data, since a crash would wipe out your back-up data as well as the original. External hard drives have become very affordable, but unless they are physically transported to a safe environment, they will be subject to the same fate as your main computer in the event of a natural disaster or fire. Fortunately, there are several options for off -site data storage via the Internet. Two popular programs for this are 

. Both download a small program onto your computer that controls the back-up of user-configurable files and folders, as well as encrypts the information before it leaves your computer. All data is stored in a secure, encrypted environment.

Another approach to backing up individual files or folders is to use the Folder Share portion of 

, which allows folders to be synchronized and stored on any number of computers at multiple locations. If your EMRs are kept in a folder, that information can be backed up simultaneously on multiple remote sites. A much more extensive synchronization plus collaborative function is provided by 

, which is available individually or as one of nine programs in 

. Incidentally, if you have any children in school, you qualify for the deeply discounted software available on 

. This service allows you to designate a computer you would like to back-up and assign another of your computers as the storage computer, allowing you to control up to five computers remotely for free. Thus, if your EMR is at the office and you do not have the IT support to enable you to view that information from outside locations, LogMeIn will allow you to access your office records from any computer.

Each of these programs allows you to create encrypted back-ups that do not require user input after initially configuring the program. You are strongly urged to plan your back-up and restore strategy using one or more of these programs.

Healthcare IT Advisory Board member. He is also chief of neurology and medical information officer at the Baton Rouge General Hospital in Baton Rouge, LA.

It would be impossible to overstate the importance of backing up your practice data. This is especially true in this era of electronic medical records (EMRs). In fact, the HIPAA Security Rule...

Back up That Data!

Technology is truly transforming healthcare. Electronic medical records, more precise prescribing, and Web-based access to scanned images enabling specialists in another state or even country to review a patient’s case are all exciting innovations in healthcare technology. The Internet has shown limitless promise in patient care by enabling unprecedented access to medical information and allowing physicians to communicate instantaneously with each other anywhere in the world. Unfortunately, this tool is also being used in a counterproductive and malicious manner.

A host of websites have emerged that enable unbridled criticism of physicians, often with little or no basis in fact. Physicians have been bound by confidentiality laws for years. But patients can now go on websites like 

 and make outrageous, often inflammatory statements that can do serious damage to a physician’s reputation. The misinformation posted is often anecdotal, statistically invalid, and impossible to verify. Attacks often come anonymously, providing no recourse for the physician and no accountability on the part of the disgruntled poster. At first glance, there appears to be little physicians can do about it. But it is possible to take some of the methods used to help physicians defend themselves against meritless malpractice lawsuits in a court of law and adapt them to help physicians defend themselves against defamation in the court of public opinion.

Uncommon Solutions for an Uncommon Medium

In other mediums, such as television, radio, and print, defamatory and untrue statements can be addressed by filing a libel or slander lawsuit in civil court. But the Internet is different. The courts have held that Internet Service Providers (ISPs) are only a vehicle for user-generated content, and are thus not responsible for that content. This means that physicians can’t sue an ISP that publishes false and defamatory content about them in the way that a physician could sue a newspaper, magazine, or broadcast station.

But there is a solution—one that uses well-established tenets of contract law. By crafting proprietary contract language, patients are asked beforehand to respect their physician’s privacy on the Internet. In order to be successful in making medical malpractice law fairer for both patients and physicians, physicians can design&mdash;and have a patient sign&mdash;a contract that benefi ts both the physician and the patient. Such a contract asks patients before care is delivered to respect their physician’s privacy on the Internet in the same way that the physician respects the patients’ privacy. In exchange, the physician grants patients privacy protections well beyond those mandated by HIPAA.

With such contracts, patients reserve the right to file a lawsuit in the event that a genuine dispute takes place. However, the patient and doctor must agree to use “expert” witnesses only from the doctor’s specialty, and these experts must be board-certified and agree to abide by the code of ethics designated by their specific specialty. In my experience, patients are willing to sign such contracts. Among physicians with whom my organization has worked, 

 at a rate of less than 2% per year, while the national average is around 8-12%. There can be no doubt about the need for measures that protect physicians from defamation. Patients can post whatever they want on an increasing number of healthcare-specific blogs and doctor review websites, with little or no policing. A single, disgruntled individual, masquerading as many patients, can post multiple entries and opinions.

Posts can also come from “competitor” physicians, or a former member of the office staff with a grudge. The purpose of the contract is to enable the physician to force an Internet service provider to take offensive material down. Established case law suggests these contracts are enforceable. In recent years, the courts have upheld contracts and enforced confidentiality agreements in cases involving anonymous employee bloggers who uploaded private information about their company onto the Web. The rulings in these cases support the view that patient—physician contracts will be treated similarly by the courts.

This is not to suggest that publishing physician outcomes is not important. But if physician rating sites are to have any real value, the information they present must be verifiable and statistically valid, like the information presented on sites with rating surveys, including 

. Contracts can embrace the use of such surveys that actually inform. That way, the public has better information, and the doctor is protected against abuses from which he or she would otherwise have no recourse. The main goal of all this is better patient care, something that is best accomplished when the doctor and patient work together as partners, and when the relationship is based on trust. At fi rst glance, having a contract that defines the rules of engagement would seem to do little to support trust. But I’ve found that the opposite is true, and the reason is that a key part of that trust is effective communication.

Jeffrey Segal, MD, is a board-certified neurosurgeon and the founder and CEO of Medical Justice Services Inc, a firm that provides doctors with a proactive way to deter and defend themselves against frivolous medical malpractice lawsuits. He may be reached through 

Technology is truly transforming healthcare. Electronic medical records, more precise prescribing, and Web-based access to scanned images enabling specialists in another state or even country to...

The Rating Game

 No, it’s not a Reynold’s Wrap rendition of a WWII German soldier helmet. The 

 actually prevents and reduces brain damage in infants born with moderate to severe hypoxic-ischemic encephalopathy (HIE), “a potentially fatal injury to the brain caused by low levels of oxygen,” by working with a system to maintain “a steady fl ow of water at a selected cool temperature through a cap covering the infant’s head.”

 Turn patients’ arteries into the ultimate marbleworks with these 

, currently in Canadian animal studies. Magnetically pushed through the bloodstream via MRI machines, they can be used to view artery interiors, pass medications, and more. 

 Painkillers and triptans be damned. Now, zap, zap, zap away migraines before they start, with the radar gun-like 

 (TMS) device. TMS delivers an electrical charge when held to the back of the head, meant to interrupt the aura phase of a migraine before it leads to a headache.

 For those high-class patients suffering from nyctophobia, not to mention those high energy bills resulting from typical night light use, designer Sun-Young Lee has created a 

 that only stays lit while sand runs through; plus it looks really cool.

 Why use a tampon or a pad when you can use GladRags’ (nice company name!) new, reusable 

. The Moon Cup, unlike its disposable competitors, catches and holds 1oz. of menstrual flow, to then be emptied (several times a day), rinsed, and used again and again for up to 10 years; according to GladRags, that’s $800 in savings!

 Actually a pretty ingenious idea, but strange nonetheless, the 

 consists of three short rods (less than an inch long) inserted into the soft palette to stiffen the tissue and to keep

it from vibrating and leading to snoring and obstructive sleep apnea.

 Pregnant women concerned their unborn baby could be affected by electromagnetic fields fear not. New Zealander Neil Bullock has developed the MummyWrap—“a sleeveless, loose-fitting garment for pregnant women made from a light-weight copper-based cotton fabric known as Swiss Shield”&mdash;to protect fetuses from mummy’s cell phone.

 Traditional robotic locomotion isn’t suited for the gut. Paddle worms use tiny paddles on their body segments to push through slippery environments. Solution: 

, created by European scientists, who plan to add

cameras to the device that can stop or slow down at points of interest. 

 If aesthetic and psychological improvements aren’t enough, offer your patients 

 that will always be closest to their heart. BT Laboratories analyst/ “futurologist” Ian Pearson says flexible plastic electronics can be incorporated into breast implants, and the technology BT is developing could play audio, and use 

 to monitor heart murmurs, blood pressure, diabetes, or breast cancer.

 For those physicians with poor bedside manner, this 

 helps facilitate conversation through voice recognition, voice synthesis, speech recognition, and facial recognition. What patient wouldn’t feel most comfortable opening up to a one-eyed raindrop? 

Top 10 Strangest 

Information technology is definitely the current “it” topic in healthcare. Supporters have touted its ability to do everything from increasing efficiency, safety, and favorable outcomes to decreasing costs, redundancy, and adverse events. As the benefits of health information technology (HIT) have become apparent—winning converts to the cause and expanding tech budgets&mdash;the rapidly growing, dynamic HIT industry is creating numerous exciting opportunities for physicians who are interested in moving beyond clinical practice.

Why would doctors, having gone through a minimum of seven years of postgraduate education and training, often followed by several more years of advanced medical training (in some cases bolstered by an additional graduate degree such as a MBA or MPH), seek a job in HIT? Judging from my own experience and discussions with many colleagues in the field, the routes to our current roles in HIT have frequently been somewhat circuitous. There do, however, seem to be several shared motivations: a strong sense of purpose, idealism, and a passion and vision for improving healthcare.

My own passion for HIT was ignited in the mid ’90s when I was working in a practice that had a rudimentary electronic medical record. Despite the limitations of the system, I perceived the transformative possibilities of HIT. Living in northern California at the time, I had many opportunities to become engaged in system development, as there were several HIT software vendors that were based there. I went to work for a small HIT software vendor. At the time, there were only three physicians employed by the company: a physician who worked full-time in sales, flying around the country demonstrating the system at sales calls; another who worked part-time in sales and part-time in development; and me. I was initially engaged to develop end-user, computer-based training systems, then moved to product management within the marketing department. This was an incredible education in the entire HIT vendor software development, sales, and implementation process. I was exposed to all facets of the business: helping to prepare the vendor responses to healthcare provider request for proposals, the software development process, implementations, and system data model design with the goal of data retrieval and “reusable” discreet data to be captured within the system’s database.

After several years working in the industry, I returned to the provider world, where I could be directly involved in HIT projects designed to improve healthcare delivery, conduct research to determine if the implementations were effective, and develop models of HIT implementation that could transform healthcare. I have continued to focus on the interface between software and the end-user’s workflow—designing and implementing software that truly supports end-users in their work and that makes the right thing to do also the easy thing to do. One example of this type of work involves systems designed to improve the process of prescribing and administering medications by alerting the prescribing physician to possible drug—drug or drug–allergy interactions, inappropriate dosing, and other potential adverse events. Such a system would also alert the administering nurse if there is any reason for the drug to be withheld.

I have continued to be involved in HIT while also working as a healthcare provider, participating in electronic health record (EHR), personal health record (PHR), and other e-health services implementations, as well as conducting grant-funded research in HIT. I continue to be committed to my original vision of using HIT tools to fundamentally improve healthcare. The HIT industry has seen exponential growth in the past 5-10 years, and this growth is reflected in both the expanding number and diversity of jobs available to physicians in this industry. The industry forecast is for continued significant growth and the development of additional positions to meet the demand created by clinical system initiatives. These initiatives have already had an enormous impact on nearly all healthcare constituencies and will continue to provide a fertile market for physicians with information systems expertise.

The following are several key venues and positions for “tech doctors.” We have separated the list by healthcare constituency group and ranked the jobs in each group according to influence and compensation level: the most influential and highest-salary jobs within each constituency group are listed first, followed by the more entry-level positions within that constituency.

These positions pertain to the implementation, optimization, and maintenance of HIT systems within a healthcare delivery organization. They are based within the organization and do not generally involve extensive travel, beyond presenting at industry meetings and participating in vendor-user groups and forums. Salaries vary depending on the particular responsibilities, size of the organization, and geography, but generally are not as high—with the exception of CIO&mdash;as sub-specialty physician salaries.

This role is one of the fastest growing positions in hospitals. Physicians who have served as Chief Medical Information Officer and in other executive positions in information technology are assuming this role in greater numbers. Many organizations are beginning to recognize the importance and value of having a clinician lead their information technology initiatives. At the present time, however, it is relatively rare that a physician serves in this role, and those that do usually have advanced degrees beyond their MD, such as an MBA, engineering, or medical informatics degree, as well as extensive experience in HIT.

The position of Chief Medical Information Officer on the delivery side is the most prominent and most requested role to recruit. The position is rapidly assuming greater importance due to increasing rates of adoption and implementation of EHRs, computerized physician order entry (CPOE), and other clinical HIT systems and the concomitant need to oversee the continued enhancement and modification of these systems once they have been implemented. The role of CMIO varies depending on the status of an organization’s clinical systems initiatives. It is strategic, operational, and highly consultative in nature. The position generally requires extensive experience with provider-based HIT implementations, and the physicians who occupy this role also frequently have additional degrees, such as an MBA or medical informatics degree.

Chief Quality Officer is typically an adjunct role to that of Chief Medical Information Officer. Physicians who serve as CQO are responsible for promoting clinical performance improvement and quality. CQO is a senior position that works with all departments and utilizes information technology, data, and outcomes as a foundation for performance improvement and quality initiatives.

Physicians with academic and research backgrounds are assuming increased importance. There is a growing need for systems and methods that utilize data generated by and captured from HIT systems to provide accurate outcomes measurement, which is key to improving the quality of patient care. Th ese systems are also important sources of data for translational research.

These doctors are essential to promoting and sustaining increased adoption of information technology in healthcare. They dedicate their time and energy to driving the rigorous and lengthy due diligence, selection, training, and implementation processes for EHRs and other clinical HIT systems at their practices and facilities, all while also maintaining their clinical practice. Frequently, these HIT “entry-level” physicians develop the interest and skills in this role that enable them to move on to the other roles described above.

Th ese are the companies that develop and build the systems used by the healthcare delivery organizations. Travel requirements as well as salaries within these organizations vary widely; the salaries are quite dependent on the duties and responsibilities of the positions, and the travel may be considerable.

There are a few physicians occupying Chief Executive Officer and other C-Suite positions in smaller companies. In many cases, these physicians actually were the creators, or co-creators, of the software or systems that are the basis of the company. These positions demand strong entrepreneurial skills and business savvy, as well as a keen understanding of the particular healthcare niche their company’s product is designed to fill.

Often, the physicians who hold executive positions within software vendor companies need to have experience using hospital clinical systems and information technology, as they are usually involved in the vendor sales cycle and may spend a significant amount of their time traveling to prospective clients for product demonstration and follow-up sales. These positions are ideal for physicians who are interested in HIT and may have used an EHR in their clinical role in the past, but who do not have formal training or HIT implementation experience.

HIT product design and development is attractive to physicians with engineering or similar backgrounds. Experience using HIT systems is preferred but often not necessary for entry-level jobs in this area. Clinical practice experience is essential.

Physician consultants work at client sites and assist with implementation, staff training, and project management.

These firms help other constituencies in a variety of ways, from assisting an organization with determining its HIT needs, to vetting and evaluating systems, to performing all of the necessary tasks for implementation, optimization, and maintenance in the case of a healthcare delivery organization that has outsourced its HIT systems to a consulting firm. All of the positions listed below involve extensive travel. Consulting salaries are generally higher than the vendor or

provider constituencies and are dependent on seniority of positions.

These are senior, high-visibility positions filled by physicians with HIT experience who have often developed a national reputation and presence. These positions require strong client relations, client management, and business development skills. They usually involve extensive travel and often require additional educational

These roles require strong aptitude in strategic analysis, evaluation, and provision of solutions. Management consultants also assist with business development and performance improvement. These positions generally require several years of industry experience.

This is getting down to the pure delivery side of the business. Consultants offer hands-on support during implementation, optimization, and training. Other, still-developing arenas that provide opportunities for physicians with information systems, business, and technical skills include:

BUSINESS DEVELOPMENT AND VENTURE CAPITAL FIRMS

The physicians in this industry come from a variety of healthcare information technology backgrounds and possess valuable business and analytic skills. One famous entrant to this arena is Dr. David Brailer, the former National Coordinator for Health Information Technology.

The growing federal HIT market is creating an opportunity for physicians to serve in a variety of capacities, including executive leadership for healthcare information technology projects and information systems analysts.

The addition of healthcare branches and departments in fi rms such as Microsoft, Intel, Google, and Oracle has created tremendous opportunities for physicians.

Commercial opportunities for physicians committed to promoting wider acceptance of technology in so many venues of healthcare is a relatively new phenomenon. Therefore, there is a great deal of ambiguity in defi ning the roles, titles, responsibilities, and compensation. As the market demand increases and more positions are created and filled, physicians’ roles and responsibilities will be more clearly defined and accompanied by more substantive compensation. Organizations such as the Healthcare Information Management Systems Society (HIMSS), the Association of Medical Directors of Information Systems (AMDIS), and the American Medical Informatics Association (AMIA) are active in working toward this end.

Clearly, the opportunities for “tech doctors” are rapidly increasing and span the healthcare spectrum. The time is ripe for seeking these positions or gaining the necessary experience and training in order to be able to excel in this arena.

Holly Miller, MD, MBA, is Vice President and CMIO at University Hospitals, a community-based system that serves patients at more than 150 locations

throughout northern Ohio. Prior to joining UH, she worked as a health information technology Managing Director for the Cleveland Clinic. She currently serves as chair of the HIMSS PHR Steering Committee, is one of the leaders of the newly formed HIMSS/AMDIS Physician Community, and contributes to the efforts of multiple HIMSS work groups and task forces.

Arlene Anschel, MT, is Executive Vice President of Hersher Associates, Ltd, a healthcare consulting and executive search firm specializing in information

technology. She is a nationally recognized expert on the role of the physician in information systems.

Information technology is definitely the current it topic in healthcare. Supporters have touted its ability to do everything from increasing efficiency, safety, and favorable outcomes to...

December 2007 | Oncology Live®

Patient Safety and HIT: Adopting Aviation Guidelines?

Are Cool Handhelds and Tablets the Right Choice for Your Patients?

Back up That Data!

The Rating Game

Top 10 Strangest

Off the Beaten Path: Jobs for Tech Doctors