As we are having to defend our actions to our doctors with respect to MU hardship deferral despite going through multiple upgrades to get ready, I am getting lots of follow up questions even to the point of "Why are we still a GE customer?" from our doctors. While I would dread going to another vendor but more and more of this stuff is driven by factors outside of my control and if that day ever comes it will not be my decision at all. I really enjoy working with Centricity, sharing experiences here on the forum, etc but as unlikely as that scenario is I really do have a question in my head about CQR and why it is implemented the way it is.
I know lots of people seem to be "cloud crazy" these days and think that it is best for everyone to have cloud based services with no regard to your existing infrastructure, you city/town's internet infrastructure, etc. Unfortunately when these services don't work, malfunction, or if your internet goes down, WE (the IT department look bad) which can translate to lower raises/bonuses if you are even lucky enough to still get them in a shrinking healthcare IT economy. If you don't get regular raises/bonuses the next step is worrying about still having a job. We spent real money to get this to work and the fact that this stuff isn't working is making us explain things which we have no control over. So my question is, why are we pushing large amounts of data to GE so it can be processed "in the cloud" along with hundreds of other clinics instead of locally on my VMWare HA cluster then pushed to the Government and/or GE? I understand if GE wants to de-identify the data and get some use/benefit/$$ from it or whatever, but I would rather that be a secondary benefit to this whole process with the primary part occurring on a server here at my clinic. We have a fully staffed IT department with a state of the art data center which does not really stay busy 24/7 so it would be possible to process this stuff every night and weekend (6pm-6am+Sat+Sun=108 hours/week for us is idle CPU/SAN time).
I have a successful cloud backup solution which I set up myself along with my ISP/WAN provider and it is up 99.999 of the time. In the event that private circuit is down I can drive to the ISP if I needed a backup bad enough. I designed it that way purposely for peace of mind. My internet connection is not up all the time although it is very reliable. Even though it is reliable, the backbone may be down at times and my ISP can't even control that. If I lived in a city where I could negotiate a SLA with an ISP for Internet service, I would expect that cost to be astronomical, as would paying a monthly recurring bill to a secondary ISP to keep this up but it would be the right thing to do for business class cloud services. All of that is a moot point right now with CQR not working so I keep wondering to myself, why did they do it this way? Why don't we have a choice to do this on an additional server at the clinic and eventually send the results to the government and GE if they also need a copy for some reason?
In my case my doctors really don't want to hear an explanation about why something isn't working-they just want it to work, and currently this situation making us look like we don't know what the heck we are doing. My doctors are not techie enough to understand things like SLA, internet backbones, private WAN technology, etc. but they do understand that we may miss some incentive or get less money.
Am I crazy to think this could have been done differently?
Mike Zavolas
Tallahassee Neurological Clinic
Posted : October 14, 2014 9:32 am
