UCHealth: ‘Most Wired’ level 10!

Uncomfortable-looking author

We are incredibly honored and humbled to be awarded Most Wired level 10 by CHIME: the College of Healthcare Information Management Executives.

We were one of the three organizations, out of thousands applying, to be awarded level 10, indicating the highest achievement in superior performance and process for information technology used to improve clinical care. This is the first year that CHIME separated out the awardees into levels 7, 8, 9, and 10.

See my last blog post for some of the details of our presentation at CHIME and some of the projects contributing to our success.

It was humbling to stand by the CIOs from Cedar Sinai and Avera Health to receive the honor. Link to article from CHIME below.

CHIME Posts 2019 Most Wired’s Awards and Recognition List

What I said in my acceptance comments, and I stand by them:

At UCHealth, Clinical and IT excellence arises from Partnerships:
1. Partnership between the CIO and CMIO and our teams. We make each other better than we could be alone.
2. Partnerships between UCHealth and our vendor partners: we know that there are more smart people who DON’T work for us, than who do.
3. Partnerships between UCHealth and the CHIME community. Healthcare CIO’s are a brilliant lot. We know we stand on the shoulders of giants.
Lastly, we want to pay it forward. More than 3 health systems deserve to be level 10. ALL patients deserve to be treated by a health system performing at its best and we want to see MANY MORE health systems on stage next year.

The End of Secrecy? (a preview of a talk at CHIME19)

I’m at CHIME19 this week: the College of Health Information Management Executives, Fall Forum. Eight hundred Healthcare CIO’s and a growing number of CMIO’s are members. My CIO, Steve Hess and I are giving a talk called “Is this the End of Secrecy in Healthcare?” where we outline our (sometimes) rocky journey toward ever-increasing transparency for our patients.

We know that an informed patient is much more likely to be an engaged patient, and engaged patients have better health outcomes. So, how do we increase the information available to patients? We have to overcome inertia, fear, and sometimes, epithets.

We were interviewed by Kate Gamble of Health System CIO to preview the contents of our talk, see below.

https://healthsystemcio.com/2019/11/01/how-uchealth-is-leveraging-transparency-to-create-a-better-user-experience/

Sometimes we have to look outside of healthcare for our inspiration:

  • OpenTable
  • Travelocity
  • Wikipedia
  • Instagram
  • Yelp
  • 23andMe

Confused? Excited? Freaked out? So were we.

CMIO’s take? Is this the End of Secrecy? Yes. Yes it is.

NYTimes Magazine travelogue photos (Shinrin-yoku, and take a breath)

from NYTimes

Is this goofing off, or is this about personal resilience? Like the idea of “forest bathing” (youtube) or shinrin-yoku, I seek out opportunities during the day to pause and reflect, and walk where there are trees. Sometimes this ends up being an online article with lots of nature photos 😦 .

Hey, you do what you can.

The photos from this travelogue are pretty amazing.

And, did any of you watch the movie “Crazy Rich Asians”? The skyscraper-top boat-like structure in Singapore is apparently an Infinity Pool and is REAL (see the background in the photo at the top). Gotta put this on my bucket list.

CMIO’s take? Harken back to the tripartite model of physician burnout and resilience: a) develop a culture of wellness, b) work on improving practice efficiency and c) work on personal resilience. And ‘forest bathing’ belongs firmly on this list. Take a moment.

Doctor lottery? Really?

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.0431

This is a passionate outcry from a patient and the daughter of a patient, to improve the state of healthcare today. Why does one need to win the “Doctor Lottery” to find a compassionate, caring physician with enough time to listen for the subtle clues that indicate distress, deterioration, and to save a life? 

https://catalyst.nejm.org/patient-engagement-both-sides-bed

The author argues that patient engagement is a paradigm shift for many organizations, and that it is a clear win-win when done well. 

Both of these articles are well written and more articulate than I am. I can say, in our organization, I routinely conducted bedside rounds, where residents and students presented the patient’s history, their examination findings and their assessments and plans in front of the patient and family, and we would discuss our plans together. Even in clinic, I have my students present their data and we have a discussion about the patient in front of the patient and family. This ALWAYS leads to better understanding by all parties, and has never been an obstruction to patient learning, or to student or resident training. And generally it does NOT take longer.

CMIO’s take? Healthcare technology and paternalistic traditions in healthcare both conspire to take us away from the bedside and risk impairing communication. Lets design better communication into everything we do.

How to Actually Focus on What You’re Doing (NYTimes)

Cal Newport interviewed in the NYT

In the blizzard of our daily work and internal and external pressures, maybe think of putting the blizzard aside at times, and focusing on Deep Work (which I reviewed previously) or pursuing ONE Thing (also previously reviewed). Sometimes it takes a second or third exposure (or many more) to have a new idea really stick. Well, here it is again.

When I have the discipline to be present, to be aware of the cacophany that constantly blares and swirls around my head and consciously place it to the side for a few hours, or even an entire morning or whole day (what a luxury, but also a necessity), then I feel like I can accomplish something substantial.

Here are a few distractions pulling me away:

  • Post-office syndrome: 4000 items in my email inbox, 1000 unread.
  • External crisis: Colleagues whose Citrix or EHR (electronic health record) or Dragon (speech recognition) or other EHR-related tool does not work and “DON’T YOU KNOW I CAN’T TAKE CARE OF PATIENTS RIGHT NOW?”
  • “I would like a report pulled from the EHR and my request is too low priority, can you fix that?”
  • “I need something fixed in the EHR, can you help me?”
  • Shiny new object: “Hey, here’s a new opportunity to collaborate on a project!”

Here are a few BHAGs (big hairy audacious goals) just begging for time and effort from quadrant four (Low urgency, high importance, from Getting Things Done) :

  • Design and write a follow-up paper on EHR optimization through Sprints
  • Write the next QI/research proposal on patients viewing images online
  • Write the next QI/research proposal on using speech recognition tools in the examination room
  • Help an innovation partner company deliver a minimum viable product related to new prescribing tools linked to the EHR
  • Help an innovation partner redesign physician training for EHR
  • Help craft the vision and curriculum of EHRs role in telehealth for a national organization
  • Help craft the vision and curriculum of informatics training for medical students
  • Learn to be a better mentor: improve the quality of meetings-with and benefit-to mentees and direct reports

CMIO’s take? I realize that any ONE of my BHAGs could be THE ONE THING that I focus on and made substantial progress on. What are YOU focusing on?

“We have an electric planet” –NYTimes

Each wire runs vertically up through the mud, measuring up to two inches in length. And each one is made up of thousands of cells stacked on top of each other like a tower of coins. The cells build a protein sleeve around themselves that conducts electricity.

This is incredible: the discovery that bacteria can form chains, build a protein sleeve around themselves, and create electrical wires. I’m grateful for the clear-eyed journalists who find and write about such scientific discoveries for us lay-persons.

I’m excited to for 50th grade! (Re-inventing myself, via NYTimes article)

This is brilliant. Kids re-invent themselves each school year.

As a parent, I see my kids reinventing themselves every school year. They’ve gone through their Lego phases, their sporty phases, their drama phases, their communicating-only-via-eyerolls phases. 

Mary Laura Philpott, NYTimes

Why not, us, as adults? What a great way to encapsulate the neuroplasticity of our minds; we do know that our brains do not stagnate in adulthood, but continue to mold and change:

https://blogs.scientificamerican.com/talking-back/new-clues-to-just-how-much-the-adult-brain-can-change/

So, why do we continue on in our jobs without considering the annual-beginning-of-school-year re-invention? Remember in medical school learning Prochazka’s Stages of Change model: how our patients who smoke would go from Pre-contemplative to Contemplative to Preparation to Action to Maintenance? We see this in EHR adoption. Or perhap some go through Kubler-Ross’s stages of grief. OK, however you slice it, perhaps we do each need time and space and permission to “start fresh.”

CMIO’s take? I’m excited to be starting 50th grade! How about you?