MASH I.T. UP_020216

MASH I.T. UP
@lumenatemash
Issue 2 Feb 2, 2016
Lumenate’s MASH Unit?
WHERE IS MASH?
Go to market strategy: GTM
INDUSTRY
CHANGES?
Insights from The MASH UNIT
WHAT ARE
CUSTOMERS SAYING
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Lumenate MASH UNIT: Bringing innovation to the front lines of healthcare I.T.
MASH LOBBY
Welcome to MASH I.T. Up’s,
main lobby. Lumenate’s
weekly updates, news and
strategy for enabling
healthcare I.T.
MASH HEADLINE NEWS: Industry Focus and Key
Initiatives that effect healthcare I.T.
Lumenate in 48!
Consulting role and deep knowledge
of I.T. and apps. Hyper converged
Lumenate Today
MASH Bootcamp
2016
MASH Playbook
with cloud
collaboration tool
Weekly quotes
@lumenatemash
from customers
mCubed in MASH
MACRA/MIPS/MU
MASH UNIT Difference
HIMSS Vegas 2016 booth #727
• Dr. Gallagher Telemedicine
• vMediCloud in a Flash!
MUSE Orlando 2016
• Delivery of flash enabled
vMediCube for mixed
workloads, analytics, VDI and
EMR
TechSpring 2016 Massachusetts
• Emerging Technology Council
with Mass Digital Health
leaders and C level for eHealth
and Analytics for EMR Infrast
Response to customer weekend triage
Summit Medical Center vMediCloud
discussion and response intro to cloud
PACS team. Create and generate
HDS HFS A series AFA not certified w/
EMR’s but verified as true AFA
Update from the front-lines:
#onelumenate
http://www.crn.com/news/cloud/300079413/simplivity-takesaim-at-amazon-web-services-claims-hyper-converged-ischeaper-than-public-cloud.htm/pgno/0/1
http://www.crn.com/news/networking/300079371/partnersstunned-by-cisco-password-snafu.htm?itc=hp_tax_networking
http://www.crn.com/news/storage/300079347/elastifileraises-35m-in-b-round-for-flash-optimized-file-block-objectstorage.htm?google_editors_picks=true
http://www.crn.com/news/security/300079342/dell-securitysteals-fireeye-global-channel-chief-to-lead-worldwide-securitysales.htm
From hyper converged to software
defined storage to networking to security
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Lumenate MASH UNIT: Bringing innovation to the front lines of healthcare I.T.
LUMENOLOGY DEPARTMENT: A LOOK INSIDE
THE BODY OF HEALTHCARE I.T.
vTeleCube 2016
The future of MASH Telemedicine
Telehealth is a key initiative for
healthcare organizations today. The
Lumenate MASH Connect Team
(LMCT) consults with customers across
multiple services lines including
Neurology, Behavior Health,
Cardiology, Dermatology, postprocedure
follow-up, acute care, and
patient outreach just to name a few.
LMCT also finds several reasons for
why organizations are looking to
deploy a system including:
• reducing costs,
• improving patient services,
• avoiding hospital readmissions and
associated Medicare reimbursement
penalties,
• providing improved access to
specialists,
• educating patients, and
• expanding the geographic footprint
of the organization.
These use cases and deployment
reasons are far from a complete list
but should serve as an example as to
how broad the telehealth
conversation can be and shows the
vast number of use cases that can be
addressed.
The common theme across all studies
is that with looming physician
shortages, insurance coverage
expansion (associated with the US
state and federal insurance
exchanges) and increasing consumer
demand for convenient care,
telehealth will grow significantly. The
MASH UNIT also sees a large driver
for telehealth with shifts in
reimbursement dynamics moving
from volume to value based
reimbursement which has created a
greater sense of urgency to reduce
costs and maximize operational
efficiency. Telehealth programs
provide a great way to achieve both of
those goals simultaneously.
How do we engage?
When engaging with customers The
MASH Unit often finds that they are in
a current state of limited deployment
in a small handful of areas across the
organization but that they typically
lack a unifying strategy or architecture
to be able to accommodate a
telehealth deployment at scale. These
limited or siloed deployments were
often a result of direct purchases
made by the individual department
and often the purchases were
completely or partially funded by a
grant. In these situations, it is often
found that the systems lack technical
and workflow interoperability with
other video systems, are costly to
expand, or do not have the flexibly to
use multiple different endpoints to
deliver that video session to the end
user. Very few customers have what
could be called a scaled deployment
that is effectively deployed, marketed,
has a high utilization rate, or could
even resell its telehealth services to
other organizations.
This is where The MASH Unit can be a
value added true healthcare workflow
partner with customers by helping
them to establish a vision and
architecture strategy for deploying a
telehealth program at scale. This starts
with an nCubed approach to defining
the needs of the organization and
then once those needs are defined a
unifying architecture approach can be
developed that addresses the use
cases that are identified today and
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Lumenate MASH UNIT: Bringing innovation to the front lines of healthcare I.T.
LUMENOLOGY DEPARTMENT: A LOOK INSIDE
THE BODY OF HEALTHCARE (CONT'D)
also is flexible enough to handle the needs of tomorrow.
This is all done through building an architecture
foundation were one can add on the individual endpoints
and software to fulfill a particular use case and do that cost
effectively as well as have the security required for a
healthcare architecture that is involved in transmitting
Patient Health Information (PHI). This unified approach also
provides interoperability and helps to reduce the IT
support and administrative overhead of managing
multiple disparate systems. Lastly, the system is nothing if
it does not deliver a value to the business, and thus
defining and measuring the value is paramount to a
successful deployment.
What’s the driver?
The common theme across all studies is that with looming
physician shortages, insurance coverage expansion
(associated with the US state and federal insurance
exchanges) and increasing consumer demand for
convenient care, telehealth will grow significantly. The
MASH UNIT also sees a large driver for telehealth with
shifts in reimbursement dynamics moving from volume to
value based reimbursement which has created a greater
sense of urgency to reduce costs and maximize
operational efficiency. Telehealth programs provide a
great way to achieve both of those goals simultaneously.
Some examples of data from the industry include:
• There will be 100 million e-visits globally in 2014, up
400% over 2012.
• Most of the e-visits occur in North America, with 75
million, or 25% of the addressable market.
• There are 600 million annual primary care visits in North
America with half for problems that could be
handled with e-visits.
• 2014 is an inflection point due to changes in technology
and industry pressures to lower cost and improve care.
• Pervasive PC deployment
• Ubiquitous Internet access
• Increasing tech comfort by older adults Mass adoption
of mobile devices
• By 2024 15% of all US evaluation and management visits
will occur virtually.
• 70% of surveyed patients reported being comfortable
replacing select in-person visits with texts, email or
video.
• By 2023 17% of Evaluation & Management visits will
occur virtually.
• By 2023 262 million visits will be conducted virtually
• EMR integration to eliminate transcribing
While the term telehealth is used in this paper there are
several emerging terms for the same concept such as:
• e-health, e-visits
• connected health,
• telehealth, or
• virtual health.
Additionally, when you look at the technology involved or
versions of telehealth, you have voice, chat, video, email,
mobile applications, and geo-tagged devices. The visits
can also be asynchronous -- patient data and information
is captured and exchanged between the patient and
provider but it is not done as part of a real time
consultation; or synchronous –is essentially a real-time
exchange of information and integration into the EMR.
The MASH UNIT Approach:
MASH’s Emerging Technology Council has researched and
outlined several approaches based on the type of
community we are serving and to who:
• buy vs build
• collaboration only
• full EMR integration
• webex like experience to include VDI
• cloud based HIPAA encrypted
• Value add of doctors expertise not product
Technologies to consume are focused on various abilities
outlined throughout this section. Some are CISCO,
ZOOM, Vidyo, CloudVisit, eVisit and many others
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Lumenate MASH UNIT: Bringing innovation to the front lines of healthcare I.T.
LUMENOLOGY DEPARTMENT: A LOOK INSIDE
THE BODY OF HEALTHCARE (CONT'D)
MASH UNIT Critical Security Control
Cyber Hygiene
There is a balancing act happening in Healthcare. Policies
and regulations are pushing organizations towards tighter
data security access and disclosure. At the same time,
doctors and patients are demanding access to information.
Healthcare providers are struggling to find a balance that
satisfies the needs of both sides. Add in the rules and
regulations under the Health Insurance Portability and
Accountability Act, the Personal Information Protection and
Electronic Documents Act, and other certifications and
compliances required, and the waters get very muddy very
fast. The worst possible outcome would be to have your data
accessed by an unauthorized source, and used for
unintended purposes.
Cybersecurity risk management is a shared responsibility
among stakeholders including, the medical device
manufacturer, the user, the Information Technology (IT)
system integrator, Health IT developers, and an array of IT
vendors that provide products that are not regulated by the
FDA.
FDA seeks to encourage collaboration among stakeholders
by clarifying, for those stakeholders it regulates,
recommendations associated with mitigating cybersecurity
threats to device functionality and device users.
What is in our control and what is not?
The CIS Critical Security Controls are a recommended set of
actions for cyber defense that provide specific and
actionable ways to stop today's most pervasive and
dangerous attacks. A principle benefit of the Controls is that
they prioritize and focus a smaller number of actions with
high pay-off results. The Controls are effective because they
are derived from the most common attack patterns
highlighted in the leading threat reports and vetted across
a very broad community of government and industry
practitioners. They were created by the people who know
how attacks work - NSA Red and Blue teams, the US
Department of Energy nuclear energy labs, law
enforcement organizations and some of the nation's top
forensics and incident response organizations - to answer
the question, "what do we need to do to stop known
attacks." That group of experts reached consensus and
today we have the most current Controls. The key to the
continued value is that the Controls are updated based on
new attacks that are identified and analyzed by groups from
Verizon to Symantec so the Controls can stop or mitigate
those attacks.
The Controls take the best-in-class threat data and
transform it into actionable guidance to improve individual
and collective security in cyberspace. Too often in
cybersecurity, it seems the "bad guys" are better organized
and collaborate more closely than the "good guys." The
Controls provide a means to turn that around
CSC 1: Inventory of Authorized and Unauthorized Devices
CSC 2: Inventory of Authorized and Unauthorized Software
CSC 3: Secure Configurations for Hardware and Software on Mobile
Devices, Laptops, Workstations, and Servers
CSC 4: Continuous Vulnerability Assessment and Remediation
CSC 5: Controlled Use of Administrative Privileges
CSC 6: Maintenance, Monitoring, and Analysis of Audit Logs
CSC 7: Email and Web Browser Protections
CSC 8: Malware Defenses
CSC 9: Limitation and Control of Network Ports, Protocols, and
Services
CSC 10: Data Recovery Capability
CSC 11: Secure Configurations for Network Devices such as
Firewalls, Routers, and Switches
CSC 12: Boundary Defense
CSC 13: Data Protection
CSC 14: Controlled Access Based on the Need to Know
CSC 15: Wireless Access Control
CSC 16: Account Monitoring and Control
CSC 17: Security Skills Assessment and Appropriate Training to Fill
Gaps
CSC 18: Application Software Security
CSC 19: Incident Response and Management
CSC 20: Penetration Tests and Red Team Exercises
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Lumenate MASH UNIT: Bringing innovation to the front lines of healthcare I.T.
MASH OR: HOW WE OPERATE NATIONALLY
Why is nCubed methodology
important to healthcare?
As BDM’s leading in with nCubed is a unique difference in
the marketplace. Most people perform assessments and
believe this is consulting. It is a consulting like step. We
have turned questions and data into a formal
methodology to deliver thought leading workflow
changes to process, policy, people, product to help enable
healthcare I.T.. nCubed
OneLumenate!
We enable our clients by Consulting, Architecting,
Deploying and Managing their Virtual Infrastructure/
Cloud, Networking, Security, Collaboration and Mobile
solutions to meet the applications demands of the
clinician-led end user. With OneLumenate we Architect,
Protect and Connect your health facility, physicians
networks and labs to enable a service provider model
for healthcare I.T..
mind that the most successful healthcare projects integrate
that singular focus and passion with the work of an
effective, professional project and/or experience
1.Is the project consistent with community expectations
2.Does it enhance the institution as a community asset?
3.Does it strengthen the institution’s future and contribute
to economic sustainability?
4.Are we controlling costs and delivering value over time?
health facilities become more compliant for stages of
meaningful use so that they are able to recognize the
financial benefits from adopting meaningful use.
Building your own Task Force Team
Vendor identification and awareness
Technology Strategic mappings
Client team development
Project alignment
Why CapEx vs OpEx?
Healthcare administrators are rightly focused on achieving
the mission for patient care. They are always asking the
questions: Are we improving the patient experience? Are
we enhancing the delivery of care? It is with this goal in
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Lumenate MASH UNIT: Bringing innovation to the front lines of healthcare I.T.
MASH REHABILITATION
What are the next steps in getting yourself MASH
enabled and healthy for a prolonged life as a
MASH BDM?
Enablement
Internal training and certifications for
core team.
A. MED Student
B. Resident
C. Physician
D. Surgeon
Understanding
Healthcare
Join forums and clubs. Personal
twitter account follow who
@lumenatemash follows and stay
close
Prospecting
Key to this is overall prospecting to
enable yourself. Years of guidance
and enablement to help you create
the vision. This does not happen in 3
months, its a lifestyle change and a
journey. True vendor alignment
required.
“the people who are crazy
enough to think they can
change the world are the ones
who do” - Steve Jobs
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