November 2016 – The Undiscovered Country

Doc Prudence (a ukulele parody) about Open Notes

I’m here at CHIME16, the College of Healthcare Information Management Executives, at the fall CIO forum, speaking about Open Notes. I’m honored to be invited to speak, and even more honored to be selected as an Encore by the audience, who choose their favorite presentations for an ‘encore’ presentation on the last day of the conference. And at the end of my talk, a ‘bonus’ presentation on ukulele of “Dear Prudence” by the Beatles, repurposed to illustrate the benefits of Open Notes and the principle of information transparency in healthcare.

It has been great to be here in Phoenix learning from and sharing ideas with healthcare’s pre-eminent CIO’s.

Congratulations to UCHealth’s CIO, Steve Hess, who wins CHIME16 collaboration award

At this year’s CHIME16, the annual national meeting of the College of Healthcare Information Management Executives, Steve Hess, our CIO accepted the prestigious CHIME collaboration award. CHIME is the largest organization of healthcare CIO’s, over 900 at present count. What a great recognition from Steve’s peers to be recognized in this way.

Steve’s work with LeanTaas is groundbreaking in that we now apply machine learning tools to improve scheduling of our infusion center chairs for chemotherapy. Our hospital’s substantial growth has outpaced the capacity of our infusion center. This had resulted in patient dissatisfaction, as well as lots of nurse overtime. Steve worked with Sanjay from LeanTaas to co-develop a scheduling tool that would, with minimal adjustments, dramatically improve throughput using predictive modeling. Peak waiting times dropped by 33%, with no increase in nurse staffing or increase in facility space. Very cool. In particular, the tool can tell the nurses what to expect about their upcoming day, not just scheduled patients, but also anticipated overbooks, and can guide ‘where and when’ to place last minute add-ons to keep things flowing. Really great predictive tool. Now, our opportunity is to use this in our OR, our ED, and throughout our enterprise. This is our first big step into predictive analytics, with clever and effective feedback loops to drive change of behavior.

Congrats to Steve. We’re on a great path, thanks to your leadership.

Doctors and Long Haul trucking

(image from https://otralogistics.com/freight-services/long-haul-trucking/)

A few years ago, I remember hearing that the “information revolution” has transformed all major industries in the US except for Medicine and Long Haul Trucking. But then, he said, “Long Haul Trucking is making its move!”

I asked one of my patients about this, a few years ago, and he described to me, how, in the “bad old days” as an independent contractor, he would haul a load from Denver to Chicago, drop off, go to the truck stop, and start asking around for anyone who could give him a lead on a load to go back to Denver, and it would often be hours or a day or so of detective work.

“Now,” he said, “I drop off, I go to the truck stop — the all have free wifi — I pull up a centralized database, search for Denver destination, and BOOM, I have a list of phone numbers to call to sign up for a load, have just enough time for lunch, and then I’m off.”

Indeed, it seemed that Medicine was on its own, the last holdout from the Information Revolution, with Long Haul Trucking leaving us in the dust.

Well, that was years ago, and we’ve since seen Meaningful Use, a tsunami of Digital Health startups, the rise of Predictive Analytics for healthcare, machine learning algorithms, and self-driving cars. We are fully into the information revolution in healthcare, with the expected backlash of Physician Burnout, and existential questions of how Computers and Doctors and Patients could possibly ever get along (more on this another time).

Meantime, Long Haul Trucking seems set for its next possible disruption: self-driving trucks. With over 3 million truck drivers in the US, is this a mass-extinction event? Mass unemployment?

Self-driving trucks at a mine in Australia:
http://www.abc.net.au/news/2015-10-18/rio-tinto-opens-worlds-first-automated-mine/6863814

Former Google(rs) are part of startup called OTTO, now part of UBER:
http://time.com/4458507/otto-uber-deal-driverless-autonomous-trucks/

And this great blog “Self-Driving Trucks are Going to Hit us Like a Human-Driven Truck”
https://medium.com/basic-income/self-driving-trucks-are-going-to-hit-us-like-a-human-driven-truck-b8507d9c5961#.iuflf0u71

And, what does this next step mean for Medicine? Is IBM Watson (or some quiet future competitor) our OTTO event? Perpend.