March 11, 2009

“Pre-Habit” Work Part I

Over the next few posts, I would like to introduce the idea of the seven habits and some of the underlying principles necessary to achieve them.  I’ll start with some excerpts from Stephen Covey’s book.

The seven habits is not a quick fix program

It is the process of personal and interpersonal development requiring your best efforts and patience over an extended period of time.  It is meant to increase your capacity to achieve your personal and professional goals and develop better working relationships associates and all of your loved ones.

A habit is the intersection of knowledge, skill, and desire.  Knowledge is the theoretical component: What to do and why to do it?  Skill is the practical side: How to do it?  Desire is the motivation side:  The want to do it.

The 7 Habits are common-sense, but not always common practice.

During the beginning of the industrial revolution, there was a shift from character development to personality techniques.  In other words, a shift to appearing to be rather than actually being.  Because of the shift from the industrial age to the information age, this trend has accelerated.

This week, tell us what efforts you’ve put forward to practice shifting back to character development and away from personality techniques.  What have you been instead of seemed to be?

Becoming a better executive

Hey guys,

I spoke with Amy, Dustin, and Kyle today about an idea that I’ve been
milling around for a while now. The idea started with a simple question:

What have I done today to become a better executive? This week? This semester?

The answer may be difficult for anyone to put their finger on. However, I think it is a question perceived as important. How often do we stop and think about what we are doing to become better executives? How often do we think about what we *could* be doing? I think this is one of those things that is at least in the back of everyone’s mind. I’d like to bring it forward.

After brainstorming some ideas, I think the four of us agree that the HMIGSA Blog would be a good tool to get the conversation started on this topic.

I’d like to start with Stephen Covey’s “7 Habits of Highly Effective People”. He has some great strategies that can be implemented in both a personal and professional capacity.

My thought is this: Make blog posts starting with “pre-habits” and then the 7 habits. We’d post one habit per month. HMIGSAers can then spend the week reflecting on the habit and comment with their personal thoughts or experiences. Pretty simple, but far from easy. Eventually, as you read each others’ comments, you pick out a few gems that you think you want to try in your journey to become a better executive. You can then share those experiences with the group and we grow even more.

I think this idea solidified for me during the VA Friday Forum. After
hearing about the level of autonomy and responsibility afforded to those students privileged enough to work for the VA, I started to think I was missing out. I wanted to know more about what they were doing and how they were doing it. I wanted to know what struggles they faced and how they managed them.

Each of these two facets (7 habits and Shared Experiences) could have an immediate impact on how we think about ourselves, our degrees, our careers, and our lives.

Andrew

February 15, 2009

EMR Strategy

I was sent this 119 page pre-publication report on EMR strategies.  Below are some elements I found to be important:

  • Computer science as a discipline does not subsume health/biomedical informatics, although computer scientists can and do make major contributions to that field.  Health/biomedical informatics is more than medical computer science, drawing also on the decision, cognitive, and information sciences as well as engineering, organizational theory, and sociology with a health and biomedical emphasis that is largely lacking in the world of computer science research.
  • Specialists in health/biomedical informatics can serve a bridging function between the computer science community and the world of biomedicine with which computer science researchers are largely unfamiliar

  • In the future, health care providers will need to rely increasingly on information technology (IT) to acquire, manage, analyze, and disseminate health care information and knowledge.

  • Any systematic effort to change the medical and health information management paradigm from one based on paper to one based on IT must address two basic challenges:

    • using the best technology available today to build and deploy systems in the short term and

    • identifying the gaps between the best of today’s technology and what is ultimately needed to improve health care.

Principles for Evolutionary Change

  1. Focus on improvements in care —technology is secondary.
  2. Seek incremental gain from incremental effort.
  3. Record available data so that today’s biomedical knowledge can be used to interpret the data to drive care, process improvement, and research.
  4. Design for human and organizational factors so that social and institutional processes will not pose barriers to appropriately taking advantage of technology.
  5. Support the cognitive functions of all caregivers, including health professionals, patients, and their families.

Principles for Radical Change

  1. Architect information and workflow systems to accommodate disruptive change.
  2. Archive data for subsequent re-interpretation, that is, in anticipation of future advances in biomedical knowledge that may change today’s interpretation of data and advances in computer science that may provide new ways of extracting meaningful and useful knowledge from existing data stores.
  3. Seek and develop technologies that identify and eliminate ineffective work processes.
  4. Seek and develop technologies that clarify the context of data.

This analysis leads to six important recommendations for the federal
government:

  • Incentivize clinical performance gains rather than acquisition of IT per se.
  • Encourage initiatives to empower iterative process improvement and small scale optimization.
  • Encourage development of standards and measures of health care IT performance related to cognitive support for health professionals and patients, adaptability to support iterative process improvement, and effective use to improve quality.
  • Encourage interdisciplinary research in three critical areas: (a) organizational systems-level research into the design of health care systems processes and workflow; (b) computable knowledge structures and models for medicine needed to make sense of available patient data including preferences, health behaviors, and so on; and (c) human-computer interaction in a clinical context.
  • Encourage (or at least do not impede) efforts by health care institutions and communities to aggregate data about health care people, processes, and outcomes from all sources subject to appropriate protection of privacy and confidentiality.

  • Support additional education and training efforts at the intersection of health care, computer science, and health/biomedical informatics. Current programs of the National Library of Medicine and other institutes of the National Institutes of Health are exemplars of such support.

The senior management in health care institutions and health care payers have often taken the lead in the deployment of IT for health care. They should:

  • Organize incentives, roles, workflow, processes, and supporting infrastructure
    to encourage, support, and respond to opportunities for clinical performance
    gains.
  • Balance the institution’s IT portfolio among automation, connectivity, decision
    support, and data-mining capabilities.
  • Develop the necessary data infrastructure for health care improvement by
    aggregating data regarding people, processes, and outcomes from all sources.
  • Insist that vendors supply IT that permits the separation of data from
    applications and facilitates data transfers to and from other non-vendor
    applications in sharable and generally useful formats.
  • Seek IT solutions that yield incremental gains from incremental efforts.

 

Let me know what you think of this report!

Thanks!
Andrew

Computational Technology for Effective Health
Care: Immediate Steps and Strategic Directions
Willam W. Stead and Herbert S. Lin, editors;
Committee on Engaging the Computer Science Research
Community in Health Care Informatics;
National Research Council

This free PDF was downloaded from:
http://www.nap.edu/catalog/12572.html