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Boston Hospital CIO Reflects After Bombing

Beth Israel Deaconess Medical Center CIO John Halamka blogs on risk planning and data sharing in wake of the Boston Marathon bombing.

Beth Israel Deaconess Medical Center was in the thick of events following this month's Boston Marathon bombing. BIDMC clinicians treated people injured in the bombing, and they treated the bombing suspects after police shootouts in the days following.

All that activity has BIDMC CIO John Halamka thinking -- and blogging to share his thoughts on what the hospital might need to do differently.

Read his blog post "Reflection on the Tragedy in Boston." What Halamka's doing shows what it really means to be a "social CIO." He's taking a risk by putting ideas out for reaction before they've been filtered through planning committees, and raising problems that aren't yet solved. He's sharing ideas right away, even as the city mourns and recovers, rather than in a month or two when doing so would be safer but also less relevant.

[ For another take on the Boston bombings, read When Tragedy Strikes, It's Not Social Business As Usual. ]

Halamka (whose team earned BIDMC the no. 1 ranking in the 2012 InformationWeek 500) raises five lessons learned -- mostly tough problems yet to be solved. I'll only briefly note them here (read the blog).

1. Risk planning is "forever altered." He had most of the people from one critical IT team volunteering at a relief tent close to the explosions. None of them was harmed, but it got him thinking about risks.

2. The hospital limits remote access for security reasons -- but what if Boston's "shelter in place" order -- which restricted local people from leaving their homes -- lasted for days?

3. Same issue with access to the data center: What if people couldn't enter or leave for days?

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4. The hospital tracks every single record lookup. Should there be real-time alerting in such a crisis -- letting someone know if a record's being accessed that shouldn't be?

5. There's a clear need for a healthcare information exchange in such mass casualty situations.

This last point was Halamka's most definitive one -- and one he has devoted much of his career to solving. He and many Boston-area peers have worked for years to make slow, steady progress on the sharing of health data.

He noted that BIDMC, Massachusetts General, Brigham and Womens, and Children's Hospital all treated people injured in the bombing, and often did so with "incomplete medical information." He points to late 2014 as the target to complete a more complete medical record look-up and exchange system, which he says "would have been helpful" in treating the bombing victims.

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User Rank: Apprentice
5/13/2013 | 6:39:27 AM
re: Boston Hospital CIO Reflects After Bombing
He raises some really valid points, most of all the concern regarding the health information change. Treating people when you donG«÷t have his or her medical records available is tantamount to opting blind.
User Rank: Apprentice
4/30/2013 | 3:31:21 PM
re: Boston Hospital CIO Reflects After Bombing
For Health information exchange how do you accurately identify people without knowing their identities??? Biometric analysis?? DNA identification>?? Great points raised...
User Rank: Apprentice
4/30/2013 | 4:06:51 AM
re: Boston Hospital CIO Reflects After Bombing
He raises some very valid points, most importantly the
concern regarding the health information exchange. Treating people when you
donG«÷t have their medical records available is tantamount to going in blind.
There are so many complications that can arise if you donG«÷t have the complete past
and present medications, allergy list, or any adverse reactions to any of
these. In cases such as the Boston City bombings a complete health information
exchange could mean the difference between life and death.

Jay Simmons
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