ORQA blog

For the past two years ORQA has been listed as a Patient Safety Organization (PSO) by the Agency for Healthcare Research and Quality (AHRQ).  It has been an amazing experience to be involved with such a passionate and visionary group of people.  However, ORQA has requested to be removed from the list.

 The primary driver to request delisting is our current customers have declined to enter in to a PSO contract for various reasons.  Since we primarily market to physician groups, I've found that many do not want to lose the option to take punitive action for errors documented in our software, which of course is prohibited under a PSO contract.  In addition, ORQA's core competency is to provide the software and technical services to implement and manage a Patient Safety Evaluation System (PSES), and we feel it's in our best interest to focus on that core competency and partner with our customers, other licensed providers, and patient safety subject matter experts, letting them take the lead on managing the operation of a PSO. 

We will continue ongoing development of freely available PSES software, including support for Common Formats adverse event reporting as well as the WHO surgical checklist.

We'd love to hear your thoughts and feedback on the PSO model as well as our Open Source software, so please leave a comment.  For more information on PSOs, the AMA has published this very well thought out pamphlet:  http://www.ama-assn.org/ama1/pub/upload/mm/370/patient-safety-organizations.pdf

 Thanks,

 Mike 

Over the past few months I've really been impressed with the information filtering out about Google Wave.  It seems to combine the best features of web email such as gmail, with Twitter, Facebook, and Sharepoint, all in one bundle.  The best part is their announcement that not only will Google Wave be Open Source, but we won't have to rely on the Google "cloud" because they say they're releasing Wave server  software as open source to run private servers.

 Our ultimate goal is to tightly couple the compliance and formal tracking and communications features of Active Agenda  with the rich collaborative features of Wave to bring a comprehensive solution to healthcare to successfully manage the exponentially growing amount of compliance and safety requirements.

 Google Wave is still in its very early stages, but we're actively working on what we can, and one of the first steps is the availability of Google Gadgets based on the OpenSocial API that give realtime visibility in to key metrics tracked within our Active Agenda servers.

Feel free to click the link below to add the Gadget to your own iGoogle start page, or any other page that supports Google Gadgets.

 

 

If you add the Gadget and click the links, you'll be taken to our demo site login screen.  If the username and ID don't prepopulate, you can log in with username: 'demodr' and password: 'orqapass'.

We're eager for feedback for further enhancing the visibility and collaborative features of our applications, so please click the Login link to register on our web site and participate in the Community Forums to share your feedback.  Also feel free to call 888-408-8886 or email us at info@orqa.org anytime.

That quote is from a great New Yorker article written by Atul Gawande.  It was published a little over a year ago, but the airline crash and exemplary performance from the pilot this week brought the analogy mentioned in this article back in to focus.  

This argument is as old as PACS itself, and I've seen my fair share of battles over the years.  However, in this latest iteration of the argument bubbling up by Dr. Chang and Dr. Channin's discussion at SIIM, I'd have to argue that their perspectives are a bit different than the majority of hospitals.  In an academic setting, the school of medicine has an academic mission to be on the bleeding edge of technology, test new hypotheses, be the early adopter.  They serve the needs of the greater healthcare provider community by sharing their lessons learned, publishing papers, etc.  This mission brings some inherent risk that most hospitals, especially for-profit and faith-based healthcare organizations, are not willing to accept.  Dr. Channin brings a very valid argument that suits Northwestern and its academic mission.  Combine the mission aspect with the $$$ situation in academia by way of grant money materializing out of what seems to be thin air from various vendors and agencies, you typically have projects going on where a central IT department is neither included in planning nor privvy to any of the grant money.  I'd hypothesize the real problem Dr. Channin is facing is not a matter of ownership, but one of hospital administration and IT not being fully on board with the academic side of the mission. 

Dr. Chang's perspective and what he's accomplished at UofC is much more in line with what many large healthcare organizations are doing.
The other posts have it right, the hospital owns PACS.  The hospital owns radiology as well, for that matter.  Diagnostic imaging is a value-added service to the patient to improve their treatment experience.  PACS is a technology investment to improve the diagnostic imaging service.

As more and more healthcare organizations start to adopt High Reliability Organization tenets, key concepts such as deference to expertise and sensitive to operations will kick in and hopefully create a culture where the organization as a whole has "ownership", but different stakeholders in their area of expertise have the accountability for the success of PACS.  The IT folks should accountable for ensuring the Imaging IT systems (PACS, RIS, VR, etc) are available as close to 100% of the time as possible, and work to remove all techological barriers to successful operation of the system.  The clinical folks should be accountable to ensure the workflow meets their needs and that the system is used to its full potential.  The business managers in radiology and administration need to be accountable for quantifying how they will realize a return on their investment in PACS.  The goals of each domain inherently contradict each other and it's up to the collective team to compromise on solutions that work for everyone.

In most truly successful PACS implementations I've come across, a formal team consisting of stakeholders from each domain of expertise is who "owns" PACS, and that team is held accountable to the CXO/Board of Directors of the organization.  If hospital politics or hidden agendas prevent the formation of an effective cross-functional team, then there are much deeper organizational issues than "who owns PACS"...



Regards,
Mike O'Meara, CIIP
President
ORQA, LLC
momeara@orqa.org