I've been leading my current organizations technology strategy for many years. Some of it has dealt with virtualization, the cloud, database and infrastruture but my main focus has been on integrating the EMR, upgrading to new software, building new technologies and creating "systemness" within a large healthcare organiztion. As the Principal Architect I create the solutions to our largest problems like how do we integrate a Cancer Institute and optimize revenue. How do we optimize our outpatient centers to bill out of another system. How do we create a new Patient Portal and overlay it with our EMR and existing Portal. How do we make a non-encounter based Ambulatory EMR talk to our encounter based Acute EMR and ensure documentation is available to our patients and clinicians. How do we migrate off an EMR at one hospital and onto our centralized EMR. All these things I have done and led either as the Director of the Teams involved or as the Principal Architect. One of my greater accomplishments was opening our Miami Cancer Institute where I was the Project Director and Lead Architect. In this role I was simulataneously involved in running our Integration, Automation and Database Teams, co-leading the centralization of our registration system, architecting the Cancer Institutes technology platforms from literally the ground up and reporting in directly to the CIO and COO of the Cancer Institute on progress. We completed on time and on budget and I also led the data migration off of their Medical Oncology system so patient data was available in our EMR on Live day.

If your looking for someone who has lived the transition from legacy EMR's, stumbled through but met Meaningful Use objectives, passionately researched and advised on build versus buy options, and implemented or migrated off of multiple EMR's drop me a line. I've pretty much seen it all at this point and I understand how healthcare "ticks". I can and will draw out the plans, engage technical and operational teams and research into problems and future technologies. Heck last week I found a spelling mistake in an offshore resources GET /Encounter who was trying to add an extension in FHIR.

I can go deep or I can draw the pretty picture everyone needs for the lightbulb to go off...

If your going to advise (and/or argue passionately for a direction) it's important to understand the underlying architecture of a Healthcare System, how it affects your business, your care givers and most importantly, your patients. A Healthcare system is ALIVE! It is constantly flowing with critical data between systems within your network and outside. That data, its accuracy, timeliness and security are extremely important. Access to that data is also critical. However it's not just given away. Tapping into an EMR's data flow can occur several ways, all which have advantages and disadvantages. If you are going to custom develop a solution be prepared to understand what is actually available and via which of the several protocols out there.

I've been involved in all sorts of healthcare architecture challenges over the years from installing LIS and RIS systems to building patient portals to automating and storing documents and faxes. In some cases I've architected a interim solution to save millions until the final solution can be implemented. Many times this is harder as you have to explain, in painstaking detail, why it needs to be this way for now. To create these types of solutions you need to have a mix of understanding healthcare clinical workflows, registration, billing, HL7 integration, FHIR, automation, EMR capabilities and you need to know that whatever solution you devise, a registration person, coder, clinician or other healthcare operations person is going to have to work with it.

Technically I'm all over the place. I know how to stand up and size servers in the cloud, install and implement small HL7 connected systems to entire EMR's, determine the resources and calls needed for a specific system account to access our data via FHIR, write CCL to find problems in the database, setup a VPN with our external SaaS vendors and internal networking team and in general get things done.

I've been implementing systems and EMR's for about 20 years now. Starting with the good ole SMS Invision Mainframe to Oracle/Cerner's latest release of Millennium and Soarian Financials. I've basically grown up in the SMS to Siemens to Cerner to Oracle Health environment but essentailly all healthcare systems work the same way. Just mix and match your solutions. Currently I am the Principal Architect for our data migration and cutover for a new Invision based hospital we are bringing onto Millennium. The whole organization uses a tech matrix developed by me which is used to determine cutover strategy for each application, required interfaces, testing scenarios, contracting and, most importantly, accountability for the EMR migration. Our latest cutover is a disparate hospital system that will be joining us net new. For this Live event I'm planning a 1 month earlier Live in the Dark event where we'll integrate the systems that will be net new for pre-reging and ease into the actual Live with minimized data flowing. I'm working tomorrow to start the migration of 1 million patients into our system where I am going to facilitate the whole transition by reusung their existing MRN, creating a net new CMRN(EMPI) and provisioning a historical encounter to tie all the previous clinical data to. (Update: Live went as planned and came up 2 hours before schedule!) Ask me how historical PACS links were handled! :) EMR migrations and hospital lives are huge deals with huge financial impacts and you need a strong team of dedicated professionals to do it. Accountability is key which is why having a defined and up to date technology matrix is critical for each health system. While this page is a lot of me... I've certainly worked with and built great teams along the way. It always takes a village.