Ideal Medical Practice Workflow: Vishal Gandhi of ClinicSpectrum Has An Infographic!

[This is the first in a series of blog posts about medical practice workflow, to be published during the #MGMA14 Annual Conference at Las Vegas, Nevada between Oct 26 & 29th.]

It’s so great to meet a kindred workflow soul, such as Vishal Gandhi of ClinicSpectrum! Vishal was educated as an Electrical Engineer. I have many degrees and the engineering degree’s been most valuable, by far. Vishal, like all engineers, applies the kind of “systems thinking” that’s frequently wished for in healthcare. He conceptually (and sometimes really!) takes a system apart. Understands all the component subsystems. Understands the workflows among these these components. And then puts them all back together, working faster, better, cheaper.

(The following workflow diagram is not Vishal’s Ideal Medical Practice Workflow Infographic. That appears in the last blog post in this series. But it is based on my schematic interpretation of his workflow infographic.)


Now, I’ve tried just about every possible way to explain workflow. I won’t list them here. But one thing I’ve never tried, is Infographics! So I’m delighted to mention here that I’m sort of acting as a sounding board to Vishal while he puts together what I think will be an unusual and valuable Ideal Medical Practice Workflow infographic and whitepaper. Vishal has created some incredible annotated graphical material. While the white paper will be forthcoming after the Medical Group Management Association conference, I’ve gotten his permission to leak some of the best bits here, in my blog devoted to EHR Workflow Management Systems and related technologies.

We’ll drill down into the component subsystems of Vishal’s Ideal Medical Practice Workflow. And then put them back together: faster, better, cheaper!

By the way, please weigh in! Tell Vishal and me How The Cow Ate The Cabbage here, as a comment. Or tweet Vishal (@csvishal2222), @ClinicSpectrum, or me (@wareFLO).

Here are the links to the upcoming posts. Some of them may not work yet, because the posts they link to haven’t been published yet. However, they’ll all be live by the end of the MGMA conference.

In my increasingly infamous 10-part in-the-weeds health IT interview series, I usually combine all the questions and answers in one post. I update the post every couple hours during and health IT conference and tweet out links to anchors within the post. As we’re dealing with infographics here, each a 100K and a screenful high, I’ll be breaking this “interview” into 10 separate, but interlinked (Next, Back) blog posts.

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Wearables + Things 2014 Trip Report: @MrRIMP and I Had a Blast!

“My choice for best of show would go to Mr. RIMP.”

During the last couple days I had a blast at Wearables + Things 2014 just across the Potomac from Washington DC. Pete Erickson and Jaimey Walking-Bear threw a great conference about the union and intersection of wearable technology and the Internet of Things. I was there to show off my little “Peds-bot” called Mr. RIMP (Mr. RIMP Is Looking For Few Good Pediatricians & Child Life Specialists: Robot-In-Your-Pocket!) and to network and learn as much as I could, which turned out to be whole a lot!

The numbers and statistics and dollars associated with, and predicted for, Wearables and the Internet of Things are astounding. One of the great things about W+T was how it combined “Golly-Gee-Wow” with more sober assessments of both opportunities and obstacles to wearables everywhere on our bodies connected to (potentially) everywhere in the world.

I gave a couple of presentations, plus had a demo table for putting @MrRIMP through his paces (though he has no feet, RIMP stands for Robot-In-My-Pocket).

Here’s the abstract from one of my presentations…

There was a fun fashion show. My wife got a kick out of this photo of a bride in a wedding dress wearing the white (Cotton) Google Glass.

(Do I get to go some great parties, or what!)

One of the great things about in real-life face-to-face conferences is the importance of luck and serendipidy in who you happen to meet and what you happen to talk about. But luck and serendipity can still use a bit of shepherding and that was what Pete and Jaimey do especially well. For example, at 7:50 AM on Tuesday, Pete walks over to tell me that the Undersecretary for Science and Technology for Homeland Security will be having a conversation about potential for use of wearables and IofT tech by early responders to rapidly emerging and evolving disasters. Pete says, hey, maybe personnel might find uses for Mr. RIMP in engaging with, and reassuring, anxious children. So I walk over, wearing Mr. RIMP in my pocket. Someone greets me at the door, asks about Mr. RIMP, and we talk about the exact idea just proposed to me by Pete. Turns out I was talking to Reginald Brothers, Ph.D. (EE/CS MIT) the Undersecretary himself! He even mentioned Mr. RIMP and pediatric early responders in his remarks. Afterwards I got to talk to the Deputy Directory, First Responders. Cool. Luck. Serendipity. Plus a nudge! :)

One of the coolest themes about W+T was how people identified themselves. At least three people who stopped by my demo table self-identified themselves as “Inventor.” One proudly noted they were a third-generation inventor. And I get the following selfie with Lonnie Johnson, the inventor of the Super Soaker.

Here’s another inventor. I told Sean about this Paper Airplane Machine Gun.

And Sean said he was going to create a robot dog that poops origami! Which in turn led to a flight of whimsical ideas, hilarious at the time, which I’ll spare you (a proverbial you-had-to-be-there moment). Turns out he wrote the first Java 2 Micro Edition (J2ME) app for the Motorola i85s phone I had in 2001. It was a tip calculator I remember using! I was in the developer program, which he ran. #SmallWorld

All the W+T presentations were fantastic. W+T has so much potential for the healthcare. Health IT can learn so much from what makes wearables “usable.” Platforms and architectures “behind” the hardware to make it usable are really pushing the envelope of security and workflow management. I’ll close with just a couple tweets about several talks that have lingered in my thinking about the conference.

I was especially delighted to hear Timothy Jordon, of Google, who is sort of Mr. Google Glass Developer in my mind, talk about such topics as notifications and glancibility.

These are topics I’ve frequently tweeted about with respect to what electronic health records and health IT can learn from the wearables space.

I’m involved in occasional discussion on Twitter about application programming interfaces and workflow technologies. So I attended an interesting presentation from @ClickSlide about the layer of software they’re creating between APIs and user interfaces. It’s fascinating to me to see how #LessCode declarative approaches to app creation (resembling, to me, how workflow tech can be used to manage software business logic complexity).

And I caught an overview of wearable security issues, and corresponding best practices, in which the following was IDed as the “take-home slide.”

Serendipitously, :), I saw a tweeted link to a previously unpublished essay about creativity from the great science fiction novelist (and Ph.D.ed scientist) Isaac Asimov. Everything he describes, about creativity, inventors, and meetings to share and stimulate innovations, are true of all the MoDev conferences I’ve attended.


Finally, I’ve to give a shout out to some folks who stopped by tell me what they’re up to in this space:

P.S. I’ve just got to add the following screenshot of logos from the MoDevWear. The blue Robot-In-My-Pocket logo on the middle row right is Mr. RIMP’s logo!


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Nov 5: My Free Webinar on EHR Workflow Engines, Editors, & Visibility

My webinar is at Noon, EST, Nov. 5. Here is the link to webinar registration page.

This webinar is not just for physicians. It’s for patients, providers, payers, policy wonks, and politicians too. Literally everyone, who comes into contact with healthcare workflows and processes, is affected by our workflow-oblivous information systems!

[Following tweets added 10/17. Skip the tweets!]

We (”workflowistas” on Twitter) are making remarkable strides in raising Health IT awareness about the importance of healthcare workflow and relevance of workflow technology. Unfortunately some of this progress is due to the unfolding tragedy of Ebola (missed) diagnoses and (mis) management. Whether or not EHR or human or some combination of workflow is to blame, EHR workflow has entered newspaper, cable news, and blogosphere headlines in a way not previously seen.


In this webinar, I’ll cover the basics:

  • What it workflow?
  • What is workflow technology?
  • What is a workflow engine?
  • What is a workflow editor?
  • What is workflow visibility?

And why healthcare so desperately needs the above, embedded in the EHRs and health IT systems we use daily.

Even if you already are a workflow expert, and know the above topics, I hope you’ll attend and show your support. I’m trying to make “workflow,” the problem, and “workflow tech,” the solution, into first-class health IT topics, up there with Social, Mobile, Analytics & Cloud.

Help coordinate and educate health IT about the process-aware angle on understanding and managing healthcare tangled workflow problems. Follow me on Twitter at @wareFLO or contact me with this blog’s contact form.

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Xcite Health Pediatric EHR Webinar Features Ex EncounterPRO CMIO Dr. Webster On EHR Workflow

(Webinar registration link!)


Here’s the official webinar description:

Award-Winning Pediatric EHR Workflow System is
Back and Better than Ever

(My original title was “3-Time HIMSS Davies MU Stage 2 Pediatric EHR Workflow System Is Back!” but it was deemed to wordy. In retrospect, I agree: boo-boo!)

Torn from the headlines: “EHR Workflow Flaw Led to Initial Release of Ebola Patient.” Workflow has suddenly achieved its place in Health IT’s sun that Charles Webster, MD, MISE, MSIS has always believed it should. Dr. Webster, “Healthcare IT workflow & Business Process Management expert,” is a frequently quoted in the news about health IT workflow issues. On November 5th, at 12 noon EST, he will layout the ABCs of EHR workflow tech: workflow engine, workflow definitions, and workflow visibility. Following, Pediatrician Dr. George Rogu will describe exactly how a true EHR workflow system dramatically increases his productivity and patient satisfaction. This webinar appeal to pediatricians and other primary care physicians, plus anyone interested in healthcare workflow and workflow technology.

Here’s the webinar background:

Very influential on my thinking about EHR and health IT workflow and workflow technology was my experience as Chief Medical Informatics Officer for an EHR called the EncounterPRO Workflow System. During the 90s I developed the first medical informatics curriculum to equally emphasize medicine, computers, and business. When my wife moved from Pittsburgh to Atlanta, a hotbed for health IT, I went to the HIMSS conference in Atlanta, resume in hand. I looked at dozens of EHRs (yes, there were that many!) but didn’t like any of them. They were all basically Microsoft Office clones. Too much clicking! But then I saw the EncounterPRO EHR — big buttons, automatically presented screens, user-customizable workflows — the Industrial Engineer in me (MSIE, Illinois) realized I was looking at a classic workflow management system.

I loved my time at JMJ Technologies and then EncounterPRO Healthcare Resources. It was the perfect match between my own background (Accountancy, Industrial Engineering, Artificial Intelligence, and Medicine) and the kind of true workflow automation that we see so little of in healthcare, until recently. Our customers won the first three ambulatory EHR HIMSS Davies Awards. (Unconfirmed rumor: judges picked us the fourth year too, but, well, you can understand how that made our competitors feel….)

I’ve moved on. I now do for an entire industry what I used to do for EncounterPRO, educate and market about healthcare workflow and workflow technology. I sometimes refer to myself as a CMIMO: Chief Medical Informatics Marketing Officer! :)

So I was delighted when I learned that the EncounterPRO Workflow System was rebranded as the XciteEHR from Xcite Health. And, (important), EncounterPRO/Xcite EHR just achieved Stage 2 Meaningful Use certification. If you know me, you know I have mixed feelings about MU (I can hear a couple chuckles out there). Nonetheless, Stage 2 MU certification is still an impressive technical and marketing achievement. Congratulations Xcite Health, for polishing a diamond-in-the-rough and the certification.

OK! That’s the background!

On November 5th, at 12 noon EST, I’m keynoting a webinar from Xcite Health. Basically I’ll be talking about what I always talk (and blog and tweet) about: workflow and workflow tech in healthcare. I’ve been convinced for years that “workflow” will join SMAC (Social, Mobile, Analytics, Cloud) as a “Big Idea.” But I didn’t know how: Ebola.

Inadvertent release of a patient infected with the Ebola virus was blamed on EHR workflow. Suddenly “EHR workflow” was everywhere on social media and health IT trade journal websites. As Dr. Workflow on Twitter, lots of folks contacted me for comments about what may have happened. You can read my series of blog posts here. So, what I’ll be talking about during my webinar with Xcite Health will be the ABCs of EHR workflow technology and their relevance to EHR workflow in the news. Then George Rogu, MD, pediatrician specializing in international adoption, will then talk about using a true EHR workflow system in pediatric practice.

P.S. I’m very active on Twitter at @wareFLO, where I tweet about healthcare workflow and workflow technology, and cat videos. If you’re a fellow or fellowess twepe, be sure to tweet me just before my webinar. I’m hoping to give a shout out! :)

P.S.S. Here’s the portrait version of the above banner announcing my webinar. Feel free to grab either and plaster them on your blog or tweet them out. Be sure to let me know, so I can return the favor. We Workflowists gotta stick together! Viva la workflow!


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Mr. RIMP Is Looking For Few Good Pediatricians & Child Life Specialists: Robot-In-Your-Pocket!

Mr. RIMP is a Bluetooth-controlled, user-customizable, animatronic “pocket-protector” for pediatricians and child-life specialists to entertain patients. We’re looking for a few good beta testers to help make @MrRIMP smarter, funnier, and nicer! You can contact us though this blog’s contact form or through my or @MrRIMP’s Twitter accounts.


Here’s a video of @MrRIMP 2.0 (yes, he has a Twitter account!) that @HIMSS blasted out to 50K+ twepes! Thanks @HIMSS!

I’m hard at work on @MrRIMP 3.0. Here’s 2.0 and a 3D-printed prototype body for 3.0. I control @MrRIMP from Google Glass (so can do a ventriloquist act) but intend for him to be controllable from iPhone and Android smartphones too.

If your interested in more demos and a longer explanation of what I and @MrRIMP are up to, here is my 15 minute standup routine at the Wearable Technology In Healthcare Conference. (Turn your sound up!)

October 21st @MrRIMP and I will also be appearing at the Wearables+Things Conference in Washington DC .


My long-term goal is to make @MrRIMP smaller, smoother, rounder, smarter, funnier, and nicer. We’re looking for a few good pediatrician and child life specialist beta testers! You can contact us though this blog’s contact form or through my (@wareFLO) or @MrRIMP’s Twitter accounts.

P.S. Feel free to use the Robot-In-My-Pocket logo and link back here! Or to Mr. RIMP’s website, when its available.


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