EMRs and Meaningful Use

He's a horror story that is clearly not meaningful use.

Doctors and other clinicians are busy. EMRs have to have an obvious benefit to attract use. Complaints that providers would rather go back to paper just says we aren't paying enough attention to good design in the data flow of the EMR.

Social Media

It's all the rage to talk about using new forms of media for selling your goods and services. To be seen as a cool company by many, you need a facebook and Twitter presence. Despite the countless Tweets about how to make social media pay, the people I have talked to are having a hard time quantifying the payback.

Personally, I have found facebook to be a great way to reconnect with old friends, as well as keep in better touch with local friends I only see every month or so. As the piece of flair that one of my cousins sent to my 72 year old father said, "facebook - now with old people".


My personal experience with Twitter has been much less satisfying. Perhaps I'm not following the right people, but it doesn't seem to be adding much. Although the NYT says that Twitter is not for teenagers, I haven't found it to be for many of my contemporaries yet either.

Dave Winer suggests that Twitter and facebook are too ephemeral, and is especially upset about the possibility that all the shortened URLs in Twitter will disappear someday. He wants us all to blog, and to store the content is a simple text file.

My 20 year old daughter, on the other hand, thinks no one is interested in blogs. But she does read my family blog, which has been the greatest pleasure I get from social media.

So, where is all this going? For my post, I'm not so sure. For social media itself, no one is sure. There are a lot of different ways to communicate today, both personally and professionally. In both contexts, we need to choose the media that's right for the message and use it.

Leaders

Leadership is scarce because few people are willing to go through the discomfort required to lead.

Seth mostly talks about marketing, but after reading this excerpt from his book Tribes, I'll be buying that (on the Kindle for iPhone)

Home Care's place in the Health Care debate

Despite my obvious bias after 18 years serving the home care industry, it is simply unavoidable that care in a patient's home is cheaper AND better than forcing people into other places to live when they need care.

Please read the information on this site:
Help Us Choose Home

Health data entry

In an earlier post, I talked about how much work it takes to enter your own data directly into Google Health. Wired magazine had an article recently about how Nike has changed that for thousands of runners. Chris Anderson, author of Free, would like the way they used free software to sell shoes.

The trade off that people make by giving away their data and by sticking with a certain brand seems to be worth it to them to have their running history easily accessible. We need our health records to be as easy...

Enjoying the job

As a leader, a big part of what you need to do is recognize what people are good at, even if they don't recognize it themselves. Putting people in a position to utilize their strengths will enable them to do good work, and they will enjoy that work. Which will, in turn, inspire them to do even more of it. Aside from watching your boss put in a good day's work, there is nothing more inspiring than getting up in the morning knowing you will able to contribute to your organization's success on that very day.

Health insurance reform instead of Health Care reform

Toby Cosgrove, CEO of the Cleveland Clinic, has a great perspective on the debate going on (from Newsweek).

The local paper has an interview with him as well.

Our job is to share ideas

Seth Godin has some very interesting insights into marketing. It's long but worth it.

Shared EMRs

I know medicine and I know computers. Since I started tracking my cholesterol in 2002, I've kept a spreadsheet on my computer. Since physical devices come and go, I switched it to Google Docs a year or so ago. In my current explorations of EMR technology, I've gotten a Google Health account and have started to enter my data into it.

It took me 10 minutes just to get the Total Cholesterol entered with appropriate history. I haven't even bothered with the HDL and LDL as separate data entry streams. My payoff was that it was easily graphed, but I could have gotten that out of my spreadsheet. My internist is a solo practitioner, which is somewhat of an anomaly. But even people going to a big practice today don't have their records at the Cleveland Clinic or Deaconess or one of the other small handful of forward thinking health care organizations that can be imported automatically into Google Health.

Isn't that where we need to get? I can't imagine those with less technical patience than we engineer-types would bother with direct data entry. And today, even if I entered it all, it's not clear that my doctor could or would use it. Nor would an ER doc know it was there. But the record may contain vital information that is relevant to my treatment.

We've got a long way to go, but the technology exists to get there. What we need is appropriate leadership that understands that.

Meaningful Use

There is still a lot of talk going on about what Meaningful Use really means.

Here is the AMA's interpretation.

People in Management

Many bright individuals are capable of supervising a small group of people, but the Peter Principle is alive and well. The best person for a supervisor position is NOT necessarily the person that does that job better than any of their peers. Certainly, that talent would put them in the extremely comfortable position where they as the boss can always instruct their staff in how to do a particular job. From there, a merely adequate ability to express themselves and a little bit of self-confidence are usually sufficient to achieve success.

The self-confidence requirement is essential, however, and I have personally overseen promotions of people without that. Its absence has resulted in definite management failure. I have not yet been convinced that self-confidence can be taught.

The next step in management, where you are supervising supervisors, takes a much larger view of the world. Most people do not excel at this. You must be able to instruct others, especially your next level supervisors, only here you are instructing them in how to lead others. You also must be an even better listener. The rule of exception (where you as manager deal only with the things that your staff is not used to seeing) comes into play much more strongly the higher up the organizational chart you go. The self-confidence requirement shifts from the need to be able simply to answer a question, to the need to really make a decision. A decisive manager, who takes the incomplete information at hand, the conflicting reports from different parts of the department and is still able to find a path to the truth, or at least his/her version of the truth, is a rare commodity. The best managers will also have the willingness and ability to go forward and implement that truth, with the understanding that if it doesn't work, he/she can and will try something else.

If you find yourself needing a manager, look for the person with self confidence who is not afraid to make a decision, even if they aren't the absolute best at doing whatever it is their staff will be doing.