AMA Joy in Medicine recognizes – University of Colorado School of Medicine

https://www.ama-assn.org/practice-management/sustainability/ama-honors-22-organizations-commitment-cutting-doctor-burnout

We are honored to be among the organizations awarded the inaugural Joy in Medicine honor. We applaud the AMA for standing up a framework that all healthcare organizations can pursue, to ensure that the work-life balance of physicians is considering in the coming topsy-turvy days of healthcare.

Physician burnout is a national epidemic, with suicide rates among doctors 2-3 times the average for US adults.

CMIO’s take? Come join us on this stage! We should not rest until ALL healthcare organizations win the Joy in Medicine award. ALL our healthcare colleagues deserve this.

The infinite game

https://www.alamut.com/subj/artiface/games/infiniteGames.html

This is a cool discussion and summary of a book about finite and infinite games. In brief, finite games are played with definite rules. Players are serious and you are either “playing” or “not playing.” Infinite games are much larger, and players can fiddle with the boundaries and the rules, players are much more playful, in a discovering mode. There can be finite games inside infinite games, but not infinite games inside finite games.

What a cool way to think about what we are doing here.

CMIO’s take: Which game are YOU playing?

SOMAlogic proteomics and the future of personalized medicine BEYOND genes

Larry Gold and the team at SOMAlogic is doing some incredible work, using the key innovation of aptamers (RNA molecules that naturally attach to proteins, and using them as nanodetectors to pick up thousands of proteins on a chip, based on urine or blood samples.

This goes beyond genomics (studying individual patients based on the genes in their DNA) to proteomics (studying individual samples from patients for the proteins being produced AT THAT MOMENT). The key insight here is that genes are inherited, a one time snapshot of your makeup. Proteins are being made every instant, and we now know that these proteins can be shut down or overproduced, in response to environment, age, stress, diet, many different factors.

Suddenly there is opportunity to study what might PREDICT a heart attack, or onset of a new disease (diabetes, etc) based on the proteins detectable in your blood sample TODAY.

CMIO’s take? Information systems do better when there’s more data. Incorporating genomic data into clinical decisions is cutting edge. Incorporating PROTEIN expression of the moment into clinical decisions is a near-future dream, that some would call bleeding edge, or perhaps clotting edge…

Generative Adversarial Networks and ‘deepfakes’

I find it fascinating that current topics in Artificial Intelligence both scares and encourages me. In this case “Generative Adversarial Networks” is a way to pit two AI’s against each other, one trying to fool the other one about an image, gradually tweaking and adding snow to a summer scene, and then the other AI detecting falsehoods versus genuine photographs. With “deepfakes” gaining traction, the ability to make celebrities (or anyone) look like they’re doing or saying something that video never captured, how will WE or our tools be able to spot these fakes?

We’re living in an age when connectivity is both a wonderful asset and increasingly suspect. What can we trust if we can’t trust a video or audio clip?

CMIO’s take? Technology acceleration, done with good intention can help us live better lives. Turns out, there are a growing number of downsides, that will require good people working hard, to turn the tide.

Because of Winn Dixie (book review)

by Kate DiCamillo, via Wikipedia

I think it is crucial to read outside of one’s vocation.

Winn-Dixie is a supermarket chain where I grew up, in Tallahassee, Florida. Furthermore, Kate DiCamillo is a magical writer, whom my children and I discovered as they were growing up. I recently found audio books at our local library (Libby app, anyone?) and have been listening to a wide range of books on my commute to work.

Not only is the storytelling just brief, and perfect, but the audio narrator is entirely charming and transports me to my secondary school years and the heavy southern accents all around me at the time. The immediacy of the memory is almost as dramatic as those times when a particular aroma (?pecan pie?) ‘clicks’ in your mind’s eye back to a specific time and place…

In contrast to what I heard from day-to-day in town, I preferred to think that MY English was derived, on the other hand, NOT from my parent’s immigrant tongues, nor from my southern-drawling friends, but from Sesame Street, Electric Company and, of course, neutral-midwestern-toned Walter Cronkite:

“And, THAT’S the WAY it is, JAN-u-ary FIF-teen, NINE-teen-SIX-ty-EIGHT.”

Walter Cronkite, CBS evening news

CMIO’s take? Well, give this a listen, or indeed, read ANYTHING by Kate DiCamillo: The Miraculous Story of Edward Tulane, Tiger Rising, any of them. The sweet, optimistic years of childhood, the purity of mystery, the tentativeness of friendship and connection…Young Adult Fiction is where its at. And, Happy holidays, y’all!

Medical Scribes: mixed methods study by Heather Holmstrom and team

https://medinform.jmir.org/2019/3/e14797/

A mixed methods study. Important work on how to reduce documentation burden and also impact physician and patient satisfaction in ambulatory encounters.

Dr. Holmstrom and colleagues at the University of Michigan did some nice work investigating the Medical Scribe model, and it’s acceptability by patients and impact on physicians.

I look forward to our technology-enabled future, where various tools assist physicians in building therapeutic relationships with their patients. Medical scribes, whether in-person, or virtual, or perhaps augmented by artificial intelligence, are an interesting experiment.

CMIO’s take: Is YOUR organization pursuing innovation in reducing the EHR burden? Let me know! And, Happy Holidays!

A Second Sprint Team to reduce EHR-related burnout! UCHealth – Colorado

https://www.hcinnovationgroup.com/clinical-it/electronic-health-record-electronic-medical-record-ehr-emr/article/21105576/uchealths-wellness-effort-includes-ehr-optimization-sprints

We are so excited to welcome another 11 person team to our Sprint Optimization family!

Our success in re-designing the physician-clinical team-EHR interaction has led to substantial reductions in time spent in the EHR: 16 minutes PER PHYSICIAN PER DAY, and in our sample of one academic medical practice comprising 26 providers (advanced practice providers as well as physicians) this “average physician” is 0.4 FTE. Sixteen minutes is already no laughing matter, but it is possible to imagine that a physician spending 100% of their time in outpatient practice might conceivably save more than 30 minutes per day as a result of a 2-week Sprint.

As you may recall, we assembled an 11 person Sprint team, 1 physician informatics leader, 1 clinical informaticist (RN), 1 project manager, 5 trainers, 3 EHR analysts (who can build and alter items in the EHR). This team arrives on site, in a clinic (of up to 30 physicians and their clinical staff) and spends 2 weeks listening, watching, building tools, and most importantly, coaching EHR use and TEAMWORK and COMMUNICATION strategies to improve care of patients as well as reducing wasted effort.

This has been noticed by our organization (UCHealth) and we are now 22 strong, 2 teams conducting sprints every 2 weeks (with 1 week of recuperation), and 15 sprints per year.

CMIO’s take? It is gratifying when the snowball effect works in your favor. We are striving to shorten the cycle-time between repeated Sprints in clinics. This is a big step in that direction.