(originally posted on November 11, 2008 at 09:55)
Quick. Name one company that does electronic health record software as a service. You might be forgiven for thinking first of those folks in Watertown, but this time I’m talking about Purkinje, that healthcare information technology company with dual citizenship (its based in St. Louis and Montréal). continue reading

Let’s talk about Vieue.

About a year ago, I finally put together one list of some of the ideas at the intersection of healthcare and information technology that I had been collecting for a while. I shared those ideas with a few friends, and the concepts that survived the sounding board were clarified, revised, and refined further. Eventually the core ideas that made it through got a name: Vieue Health.

I still care (very much) about healthcare and healthcare information technology and I think there’s room for me to positively shake up at least one little corner of the healthcare information technology world. (I think it helps when your plan hopefully skews closer to Jonathan than to Joan.)

All of this to say, stay tuned. There’s a lot I want to say, but frankly I need to find the time to write it all down coherently… (You can see I have a problem with that, right?) In fact, it might help to hire somebody to help me out with this “communications” thing. Let me add that to my list.

I’ve got to get back to actually working on all this, rather than talking about it. In the not too distant future I’ll have a bit more to share. Stay tuned!

We need to remember that we are created creative and can invent new scenarios as frequently as they are needed. Maya Angelou

Last summer, Create West Virginia was, well, created to highlight and promote creativity, technology, and forward thinking to help bring together West Virginians to advance our economy, our quality of life, and opportunities for the people of our state. To say that a little simpler: Create West Virginia is about bringing people together to find creative ways to move West Virginia forward.

I moved away from West Virginia after college, but for about a year now I’ve been spending more time back home, working on Vieue. The challenges West Virginia faces today are greater than ever, but the opportunities are just as tremendous. For many years, our state leaders in business, technology, healthcare, labor, and government seemed to be stuck in the past. That is changing.

In healthcare, in particular, I think West Virginia is truly moving forward, even though we face some of the greatest obstacles. Innovative companies like beBetter and Vested Health are on the forefront of new trends in healthcare. Julian Bailes at West Virginia University and Bob Coffield at Flaherty Sensabaugh & Bonasso are both respected leaders in healthcare and healthcare information technology. Governor Manchin has continued to move the state forward towards a statewide health information network. Mountain State Blue, through its partnership with Highmark, has made tremendous progress in helping doctors digitize. And don’t forget where David Brailer is from.

Create West Virginia has asked folks in West Virginia to talk about their hometown or where they’re from, and the creative things that are happening there. I’m from Boone County, and I haven’t lived there for quite a few years now. I do know they have been making strides in building a new economy for the area, with the successful new business incubator being an important milestone in that effort.

But over the past year, I’ve come to call Snowshoe my West Virginia home. With Vieue, I needed to find a place where a small team of folks could work hard, brainstorm, problem solve, generally break all the traditional rules of project management… And still be in a place where nature was just steps away, where you could breathe and take a moment to unwind when you need to. I’ve been coming here since I was a kid, and so much has changed. Coincidentally, a company called Intrawest has been behind a lot of the changes at Snowshoe over the past decade or so, and they call their process “placemaking.” Seems apt!

West Virginia has so many “places,” we have such a wide range of nature, from valleys and rivers to plateaus and streams to, yes, mountains. “Placemaking” here is really just complementing and not getting in the way of nature, and Snowshoe is a place that has balanced that quite a bit. For that matter, you could say the same of much of Pocahontas County. They call it the “birthplace of rivers,” since eight of them originate in the county (the Greenbrier, the Cherry, the Elk, the Cheat, the Gauley, the Tygart Valley, the Williams, and the Cranberry, if you are keeping track).

It’s pretty great, I think, that the Create West Virginia conference is coming up in just a few weeks, at it’s going to be at Snowshoe. West Virginia has so many creative places, but I think right on top of one of the highest points in the state has to be one of the best. The great thing about Create West Virginia, though, is that it brings all of us together, and Snowshoe is a great creative place for all the creative folks from all the other creative places across the state to converge. It might just be electric. Speaking of which, here’s one last Maya Angelou quote for you: I believe creativity is like electricity. We don’t understand how it works… We just use it.

Update: A lot can happen in a week. On Monday, my mother’s pulmonary specialist said he believed her condition was worsening and that she would likely need skilled nursing permanently. Given her advance directives, this was not good news to hear. I ended up having to argue with the specialist in order to get his “consent” for a second opinion. The second pulmonary specialist agreed that a tracheotomy should be a last resort, not a first option. For the last several days, my mother has been breathing on her own for short periods of time, and with a mask to help her breathe. She will soon be moved down from critical care, and in the next few days she is scheduled to be transferred to St. Francis Hospital for several weeks of recovery…

My mother had a serious heart attack on Wednesday, while she was already in the hospital for a mild heart attack and a bad case of pneumonia. I got into Charleston on Thursday, and have come to call this hospital “home” since then. (It now seems that there is no need for the apartment I rented here earlier this year, when she had several stays in the hospital. As it turns out, you can get used to something resembling sleeping, even while upright in a chair.)

All of this has helped me to realize I have come to much prefer being on the provider side of the healthcare equation.

The only distraction I have found here is pretending to care about the healthcare information technology in place at this hospital, which consists of Soarian, Opus, and still a bunch of paper. No svelte tablets or thin clients or patient room workstations, although one of the nurses does carry around a clunky notebook and there are a few other notebook carts bandied about. Workstation security (and thus information security), sadly, but not surprisingly, seems to be a fairly low priority.

There are disadvantages to working in healthcare and dealing with the healthcare system. For instance, I know that this hospital is below the state and national average for heart attack and heart failure care, but she was able to make that decision in the ambulance, and chose this hospital above my objections. Transferring her now is not an option. Sure, there’s a whole list of what the hospital can and should do to fix their substandard care rating, and healthcare information technology could even help. But none of that really matters, here and now, to me as a son.

Being involved in your care decisions requires you be awake and competent; the ventilator means my mother cannot be involved, and the propofol ensures she is not. The draconian rules surrounding chart access, and the fact that said charts still use advanced dead tree technology, present an incredible challenge just to stay up to date on my mother’s care, even with constantly being here, and even with the most patient and accommodating providers.

Will modern information technology and processes fix everything? No, but smarter healthcare information technology can be a catalyst, a conduit, and a foundation for smarter healthcare.