04 Jan

Words to live by when leading change

Advice from leading IT transformation and change managers

Five key thoughts for those leading changeFive key thoughts for those leading system change

“People who have low psychological ownership in a system and who vigorously resist its implementation can bring a ‘technically best’ system to its knees.”

Nancy M. Lorenzi, PhD & Robert T. Riley, PhD
Managing Change: An Overview
Journal of the Medical Informatics Association

Practical implications of a study on IS change management: “…management should aim to increase the perceived value of change and organizational support for change to reduce user resistance.”

Hee-Woong Kim & Atreyi Kankanhalli
Investigating User Resistance to Information System Implementation: A Status Quo Bias Perspective
MIS Quarterly, Vol. 33, No 3, Sept 2009

“Lead your organization to a successful outcome, and speed up the process by treating your staff as customers first.”

Claire McCarthy, MA & Douglas Eastman, PhD
Change Management Strategies for an
Effective EMR Implementation

“In his article, “Leading Change: Why Transformation Fails,” John Kotter of Harvard Business School lists the major reasons for the failure of large-scale change initiatives (such as HIT systems): lack of a sense of urgency, no strong coalition, lack of a clear vision, missing frequent, clear communication, dis-empowerment of staff, no creation of short-term ‘wins’ to build momentum, and lack of ‘anchors’ for a change culture.”

Gloria L. Austin, Stephen Klasko, MD & William B. Leaver
The Art of Health IT Transformation

“In other words, recognize that you are not done at go-live; you’ve just started achieving technology adoption and changing behavior to get value from your investment.”

David E. Garets, FHIMSS
Change Management Strategies for an
Effective EMR Implementation

02 Mar

PeriGen Predictions 2016

Rethinking the Labor CurvePeriGen Predictions 2016

by Emily Hamilton, MDCM
Senior Vice President of Clinical Research

We all enjoy lists of predictions for the coming year; hot stocks picks, fashion styles – what’s cool, what’s not, baby names- what’s in, what’s out and the rising or falling stars of society’s influencers, to name a few.

At PeriGen, our thoughts also turn to the future and we have prepared some projections of our own.   But first, history does inform the future. Upon reflection, the common thread throughout PeriGen’s history has been innovation.   However turning ideas into concrete solutions is much more than having a bright idea.

…turning ideas into concrete solutions that work is much more than having a bright idea.

At the most fundamental level our innovations must solve a real need in a fashion that improves the efficiency of clinicians, in a cost beneficial fashion favorable to both institutions and individuals. Furthermore they must do this in a manner that is better, safer, cheaper, faster, and more expedient and sustainable than the solution currently in place. These criteria make innovation a very tall order. Successful innovation teams focus on the problems they understand deeply, but they – when needed — also recognize and source missing resources of expertise to create novel solutions.   Failure to involve real clinicians, assessing the new prototypes in real world situations, early on when product definition is still malleable, is a pitfall that leads to failure.

With those lessons in mind here is our list for 2016 (and a bit beyond). We invite you to comment on it.

An EHR’s ability to meet the requirements for Meaningful Use, e-prescribing, health information exchanges, interoperability, and ICD-10 coding are all major considerations for health care institutions. We expect to see the trend toward EHR convergence continue.

In reverse order, here are the top 3 trends in 2016 and beyond.

PeriGen’s Projection for
Healthcare Technology Trends

#3  More Personalized and Intelligent Data Analysis

With improved interoperability well underway hospitals are searching for solid evidence of both health and financial benefits. We expect to see HIT applications specifically tailored to address underlying causes of error at the bedside, improve diagnosis and treatment, and help managers track performance in their departments.

There are only so many rules that a human mind can hold and process, especially when considering multiple factors that change over time in busy clinical environments. However, with the computational capacity of everyday computers it is possible to apply a number of well-established statistical techniques to reduce subjective and inconsistent human assessment, to assess personalized likelihood of adverse outcome and warn clinicians in time so they can change management and minimize untoward consequences.

Statistical reports analyzing trends in outcomes and processes help unit directors define, prioritize, and monitor quality-of-care benchmark initiatives. Performance measurements are essential to show where progress has occurred or where it is needed. They also help to motivate clinical teams (and individuals) with evidence of their own success or need for improvement.

We expect to see many more applications layered onto the basic EHR for intelligent analysis and data display, making it easier for clinicians to care for patients and for directors to manage their departments.

#2  Increased Use of Cloud-Based Technologies

Increasing prevalence of wearables and devices using mobile and cloud-based technologies bring individualized data to patients and clinicians wherever they are, whenever they want. Pregnant women in general are well-educated, young, and accustomed to technology. This modern reality gives rise to expectations that health records and even meaningful healthcare itself can be provided this way as well.   Not only will these technologies collect and return personalized analysis, the collective data is a gold mine for medical researchers.

#1  Expansion of Virtual Centers of Expertise

The two trends mentioned above facilitate the creations of virtual centers of expertise. Once a novelty, the virtual center of expertise is becoming common place in business and in healthcare.

Evidence of this includes:

In healthcare, virtual ICUs are increasingly common in the US.   A virtual command center staffed with nurses and doctors using high-resolution video conferencing and transmission of monitoring data can be hundreds of miles away and serve multiple remote sites simultaneously. Not only are such centers showing improvement in outcomes, patients are reporting high levels of satisfaction with much easier access to clinical expertise.

In some places the center acts as a second set of eyes, in others it is a source of consultative expertise.

By 2018, the global market for telemedicine devices and services is projected to grow to US$4.5 billion and the U.S. market is expected to grow to $1.9 billion1.

Virtual centers of expertise are feasible only with reliable infrastructure to support rapid data exchange. If gathering, assimilating and sharing information are the foundations upon which decisions are made at the bedside, in virtual centers their importance is multiplied many-fold. Although standardization may be easier to achieve given the relatively small group of experts who staff such a virtual center, they will face other pressures, such as vigilance fatigue when potentially hundreds of virtual patients are under their care at any one time.

Automated intelligent methods to prioritize the true level of abnormality and direct the expert’s attention to the most urgent issues are imperative in such centers. Good prioritization is particularly important in obstetrical situations where false alarms are common and adverse events are rare but can devolve rapidly with dire consequences.

To quote Geoff Mulgan, CEO, National Endowment for Science Technology and the Arts (NESTA) , London, UK : “As the Internet of Things advances, the very notion of a clear dividing line between reality and virtual reality becomes blurred, sometimes in creative ways.”

We project the healthcare will see an increasing numbers of virtual centers of expertise offering an expanded set of services. Our challenge will be to apply technology wisely, measure its performance, and continue to evolve it guided by the search for what is best for patients, efficient for clinicians, and cost effective for society.

“As the internet of things advances, the very notion of a clear dividing line between reality and virtual reality becomes blurred…”

What do you think?  Will these happen?  What else do you expect to change in our world this year?


1 Bruce Japsen, “ObamaCare, Doctor Shortage to Spur $2 Billion Telehealth Market,” Forbes, Dec. 22, 2013; “Global Telehealth Market Set to Expand Tenfold by 2018,” IHS, Jan. 17, 2014.


10 Feb

The Making of a Vision…

of the Future of Obstetrics

Vision of the Future of ObstetricsMeanwhile, at the bedside, forward-thinking clinicians are hungry for more 
focused solutions for long-standing challenges within their specific service lines. 
At home and in business, they have seen technology streamline and often improve their experience and they are looking for the same in their clinical practice.

Obstetrics is particularly well positioned to benefit from advanced systems. 
Suffering from high malpractice exposure, a shrinking population of hands-on 
clinicians and patient profiles with increasing complexity, many of the country’s leading obstetricians are looking to augment traditional training and education with tools designed to address specific weak links in the care process.

To this end, PeriGen, the leader in Clinical Decision Support (CDS) systems for obstetrics, assembled an advisory group tasked with:

• Describing current patient care challenges
• Prioritizing where in OB that technology can have the most positive impact
• Defining the scope of research projects to demonstrate the impact

This multidisciplinary group, comprised of obstetric chairs of top health systems, experienced labor & delivery clinicians, a leading malpractice attorney, and perinatal software creators, came together to create a road map for a new era of HIT and clinical synergy in obstetrics.

That road map, “A Vision of the Future of Obstetrics,” is now available free on the Apple Store and as a PDF download

20 Nov

Fierce Healthcare Names CheckList Finalist

Fierce Healthcare Innovation AwardFierce Healthcare, a publisher of numerous health care and healthcare IT newsletters and publications, announced that PeriCALM CheckList is among the finalists for this year’s Fierce Innovation Award in the Healthcare Category.

CheckList, introduced this year, provides hospital labor & delivery units with an automatic means of managing obstetric protocol checklists, including those used for induction.  It integrates with not only other PeriCALM modules, but with enterprise EHR systems to make it easier for clinicians to leverage the patient safety benefits of checklists.

The Fierce Innovation Awards, launched three years ago, recognize technologies that display excellence in the following criteria:

  • Care efficiency
  • Competitive advantage
  • Financial impact/value
  • Market need
  • Patient experience/satisfaction
  • Quality of care and patient outcomes
  • Innovation

The award presentation will occur during a webcast scheduled for December 9th at 2 PM ET.  Click here to register.