Brief History of Ken in Healthcare IT

Last year a U of M student found my name in the HIMSS directory and asked if she could interview me for a class project. It sounded interesting, here is part of the interview.

-Describe your current role in Healthcare IT

[Bradberry, Kenneth] My current job is the Chief Technology Officer for the healthcare vertical. This responsibility consists of providing the division and customers a strategic vision for the advancement of healthcare I.T. I also provide technical architecture solutions for the large and small application frameworks that hospitals deploy to manage clinical, financial activity and I do a ton of pre-sales technical support. I provide architecture solutions for venders like Cerner, McKesson, Epic, Meditech just to name a few. Healthcare clinical and financial applications have specific integration requirements based on the mix of products the hospital chooses to deploy. I also provide what is called a 4th level of technical support, having the engineering background, when all else fails, I get the call.

-How did you get started in healthcare systems?

[Bradberry, Kenneth] I had an interesting path to my current position. Leaving high school in 1984, I joined the Navy with the idea of becoming an Electronics Technician. I ended up receiving training to run the shipboard computer systems which sent me to Computer training and to several weeks of school. This training proved to be very useful in my professional development. I served 6 years, most of it onboard a ship operating the SNAPII (Shipboard Non-tactical Automated Processor. (which is a whole different story).

Once I exited the Navy I attended college and graduated. During my college years I started working at a local hospital as a Computer Operator. I worked weekends and pushed to get more responsibility, often getting into trouble for snooping into systems and networks that I was not responsible for, but as a result of that curiosity I learned more and more about networking, mid-range and mainframe systems. Mind you this was around 1990-93, so the internet wasn't a big deal and was an open territory just starting to take the place of old BBS dial-in systems. After getting my hand slapped a few times my employer saw my interests as an advantage and put me in charge of the few UNIX systems on the floor at that time.

I jumped in with both feet becoming a UNIX Administrator and a programmer. When you are part of a hospital I.T. department, in most cases you will wear several hats. As a primary UNIX admin, I also worked with the application venders and clinical and financial analysis to implement the vender's applications. I advanced my UNIX knowledge primarily focusing on IBM AIX, SP2 all the infrastructure associated with supporting these environments. I studied and became an IBM Certified Advanced Technical Expert and a dozens of training classes the conferences. As I mastered the hardware and infrastructure technology I started to get more involved in the deployment of healthcare applications. Hospitals will always buy off the shelf, I have seen some that attempt to grow there own applications, it usually fails miserably. After working with dozens of venders and getting experience with the different types of products they deploy, I began to expand my knowledge beyond UNIX and into different aspects of healthcare delivery.

For example, I designed the platforms that a major Labor and Delivery system would be hosted on. The UNIX systems hosted the databases and the application code, but we needed a solution to move the data from the fetal monitoring units to the database. Around this timeframe “client server” concepts were relatively new, so much of this at the time was pretty innovative in healthcare. The vender we worked with had developed a device call a DAS unit (Data Access System). It plugged directly into the fetal monitor via serial cables collected data and converted the transport to Token Ring (no Ethernet at the time), that communicated via TCP/IP directly back to the UNIX systems. Now we had a way to centralize the monitoring of fetal monitors and the ability to apply alerts and alarms to different conditions reported by the fetal monitors.

Project after project of different methods of engineering solutions to improve the delivery of healthcare, I grew into a Solutions Architect for the hospital system. So I took my knowledge of UNIX, Application deployment experience and all the other disciplines (networking, storage networking, medical devices, clinical work flow, and vender application knowledge) and applied that to creating what is called an integrated delivery system. In a multi-hospital, multi-clinic environment this takes applications like interface engines that create method of interfacing and moving patient Admissions, discharge and transfer data, lab results, etc... to all applications that patient would encounter during an inpatient or outpatient stay at the hospital. So when you go to Radiology, you are registered and the orders that are placed for you are in this system (the old way, everyone keyed in your data, creating separate databases with patient information and in a lot of cases creating errors both in the delivery of the care and the billing and inventory.

As I progressed through different projects and started to manage a staff of the different teams of disciplines I mentioned above, my responsibility grew and my titles changed. Healthcare I.T. evolves like any other industry and the hospital I worked for joined a group of other hospitals to form a Healthcare I.T. Outsourcing company in which I became there Technical Architect. After a couple of years in that organization, I had the opportunity to build a Data Center and help grow a new outsourcing business, I jumped at the opportunity. This company was primarily a consulting firm and had a good vision of where the industry was headed. We built an Outsourcing division and a Data Center to support the customers. My role had evolved from primarily an Application Technical architect, to the Chief Technology Officer, Data Center designer, facilities manager, and the Technical architect and solutions provider for the company. We had major success in the market, fully outsourcing 9 major hospitals into our Data Center. We had so much success that a large I.T. provider purchased our company and made us part of there healthcare division for which I currently serve as the Chief Technology Officer for the healthcare ITO division. Just as things continue to change, so will this at some point, and we all move on to the next interesting opportunity.

-Do you see healthcare systems as a growing or limiting field of employment?

[Bradberry, Kenneth] The future for Healthcare I.T. is bright but it's evolving. Just like the automotive industry has been changed by off-shoring, so will healthcare I.T. Having specific skills that are not easily commoditized is the key to surviving in this climate. Healthcare providers do not want to be in the I.T. business, many outsource. Outsourcers are forced to drive down costs, India based call centers as well as other areas like Canada and Mexico all provide cheap labor. India especially with there highly educated, English speaking population is the center of I.T. outsourcing for the U.S. So basic positions like my former roll as a UNIX admin can be easily performed off-shore at a third of the salary. There are near-shore solution providers as well that are taking off, Mexico, Brasil and Canada just to name a few are major I.T. providers. Technologies such as IP based KVM (Keyboard, Video, Mouse) emulation requires that only a button pusher be available if necessary, and even that can be automated when you start controlling at the circuit level each system. Even clinical tasks have been sucessfully off-shored, Google "international teleradiology" and you find all sorts of off-shore services that read for hundreds of U.S. based hospitals. We will continue to grow in Healthcare I.T., but the skills required to maintain your involvement will have to be very specific and in most cases client facing. There are still many areas of Healthcare I.T. that still require domestic resources.