A review of Agile programming philosophy. This was then used as part of a presentation at HIMSS (Feb, 2011) called "Iron Programmers", in which two teams rapidly created a software tools to solve a challenge presented to them just about 2 weeks before the conference.

1. Iron ProgrammersAgile Programming for Web and Mobile or…Why You Need to Hack More and Worry Less DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS. ©2011 Healthcare Information and Management Systems Society

2. + HIT

3. What is Agile Programming? Rapid cycles of iteration User-Centered DesignStrong customer focusand interaction

4. Why are we talking about this? Do your clinicians feel your current HIT system provides the most efficient and highest quality way to practice? Do your clinicians ever lookat your EMR system and say “How come it can’t do that”? Do you ever feel like you can’t do anything outside the scope of your current EMR system because it would “distract”from your core competencies? Do you feel like you can’tdo anything “extra” becauseit costs too much in time, resources and money?

5. Current ParadigmSlow evolution of EMR Systems GAP IdealEMR Low Impact,High Usability High Impact,High Usability MostEMRs USABILITY Low Impact,Low Usability High Impact,Low Usability IMPACT ON HEALTH

6. Current ParadigmSlow evolution of EMR Systems IdealEMR Low Impact,High Usability High Impact,High Usability USABILITY GAP EMR Evolution Low Impact,Low Usability High Impact,Low Usability IMPACT ON HEALTH

7. Paradigm shiftFocused Innovation: Niche Solutionsfor High Impact Situations IdealEMR Low Impact,High Usability High Impact,High Usability MostEMRs USABILITY FOCUSED INNOVATION Low Impact,Low Usability High Impact,Low Usability IMPACT ON HEALTH

8. What if this Focused Innovation could… Solve an immediate need Provide an easy and cheap way to "pilot" or test out a new concept or workflow Allow you to be more creative in your approaches to problem solving Create the building blocksor direction to help guide development of morerobust solutions withinyour EMR system

9. The Story of ExpectED

12. Create a software program which allows an outpatient physicians to easily send a “Handoff Note” to an Emergency Department via Web or Mobile technology Mandatory fields Patient name Physician name Clinical Summary(Reason for sending to ED) Optional fields Patient DOB Physician contact info(e.g. pager, cell…) How evaluated by physician Method of transport Time expected in ED Preferred consultants When to contact Physician Where is additional patient data available, Expected disposition Requested outpatient follow-up

13. Team One Jon Baran Ash Gupta www.healthfinch.com

14. Team Two Hunter Whitney Doug Naegele

19. For further information… Lyle Berkowitz, MDCEO & President,Back 9 Healthcare Consulting Email: lyle@DrLyle.comWeb: www.DrLyle.comBlog: www.drlyle.blogspot.com