From Arthur C Clarke to Rediscovering Carl Sagan in an APOD video from 2014

Artist’s impression of the interstellar asteroid `Oumuamua

I am a fan of APOD (Astronomy Picture of the Day). Today’s picture is of “Oumuamua” the first large asteroid detected outside our solar system. Amazingly looks like RAMA from Arthur C Clarke’s novels.

And somehow I followed my procrastination monkey (you have GOT to watch this TED talk) (see what I did there?) to the link below and wonderingly listened to Carl Sagan’s voice from decades ago, speculate about humanity’s future to the accompaniment of amazing speculative images of space exploration.

CMIO’s take? It is a big world out there. Sometimes look beyond your own horizons and dream a big dream.

Slicer Dicer: UCHealth providers carve up data to bolster care (article)


Thanks to my good friend Tyler Smith, a freelance writer who published this article in the UCHealth Today newsletter, on how our doctors, nurses and staff are using Epic EHR data to improve care, through an innovative self-service analysis tool that even busy providers can use to create and run reports of “missed opportunities” and get patients the care they need (vaccines, screenings and the like). Thanks for the great write up!

CMIO’s Take? The Health IT world of EHR’s needs a better, more consistent way to share our successes; all the great work we are doing. The perception from many is that “The EHR is just a black hole. You give and give, and nothing every comes back out that is useful.” Well, we beg to differ. We just need to get the word out so more people know. How is your organization doing this?

Addendum: Happy thanksgiving everyone – hope you all have a great break.

Book review: With Wings Like Eagles


Five stars.

Okay, this is a Costco book. I’m a sucker for that big table in the entryway of Costco. I sometimes will walk through just to see if there’s an interesting book to pick up; with the precondition that its a good deal on an inexpensive book, as they all are, by definition, at Costco.

So what do you get for your $8.99? I really enjoyed Michael Korda’s broad brush strokes of the Battle of Britain. He starts with the fall of France, briefly touching on Dunkirk and the evacation of the British Expeditionary Force, and the relative ineffectiveness of British fighters tangling with the mighty German Luftwaffe overhead.

Then he really gets going, diving into the just-in-time developments of radar, the Bentley Priori where all the signals came together, the buried telephone lines hardened by concrete, the segmented and disciplined use of British fighter squadrons. Each element could not have succeeded without the other.

Furthermore, Korda delves into the minds of the German leadership; the tragic underestimates of British fighter strength, the underestimate of the power of radar, the underestimates of civilian resilience to bombing, and finally, the shift in strategy to bombing London.

And then, the role of serendipity in the war: if it were not for a mistaken bombing attack on the outskirts of London, Churchill may not have insisted on a bombing run at Berlin, which in turn enraged the Fuhrer who insisted then on obliterating London. This move gave a last minute reprieve to the Spitfire factories and airbases that were at breaking point, since bombing London meant bypassing the real military targets nearby.

Finally, the Channel and the weather were the final brackets around this drama: the closing of the weather window put an invasion out of reach for the rest of the year, as the Channel was too dangerous for a mass crossing after September.

I read this book, after reading The Myths of War, and wanted to hate it, with my new appreciation for the mistaken belief that War is the ultimate arbiter, that civilians are not harmed, that military struggles are just too messy and disrupt too many lives to be worth it.

And yet, this book sings to me: the political intrigue and the faults of leaders, the management and mismanagement of those in hierarchies, the unappreciated insight of one man in a position to make a difference, the nail-biting mano-a-mano of mono-wing fighters, a brand new technology, the innovative use of radar, the difficulty of guessing what your opponent is about to do, the strategy of setting the RIGHT goal for a situation (playing a delaying tactic and defense since the weather will help, versus playing an aggressive tactic).

As Churchill famously said in August 1940: “Never has so much been owed by so many, to so few.” Air Marshall Dowding, who  unceremoniously left the service only  a few months after this Battle had his faults, but also his great insights and successes. The world would be a very different place without him.

CMIO’s take? There are leadership lessons everywhere. Insightful use of technology, combined with innovative people and process, can tip the balance of history. The backstory on this thrilling chapter is not to be missed. And then of course, British Spitfires have been the coolest thing ever, since I was 5 years old, anyway.

Ukulele: Dear Burned Out Colleague

Ukulele at CHIME17

Ukulele at Epic UGM17 CEO Council

Thanks to the organizers at CHIME17 for a great conference. Just returned from giving my presentation on “EHR 2.0 Sprints: Can Providers and EHR’s Just Get Along?” with my collaborator and colleague Steve Hess, CIO at UCHealth.

We are all about improving the well-being of our provider colleagues using the EHR by developing our 2-week in-clinic technology sprints to improve provider efficiency. We created an 11-person team, led by a physician informatics, managed by a project manager, with a clinical nurse informaticist, 4 Epic analyst-builders and 4 Epic trainers. Their main directive: “Go in there and make things better, but whatever you do, you must be done in 2 weeks.” They spent 1/3 of their time on building new, specialty-specific custom tools and 2/3 of their time on training efficiency strategies on the existing EHR tools. Most importantly, they created a people/process/tools conversation and redesigned quite a few workflows.

We measured Net Promoter Score (NPS: range of -100: terrible, to +100: perfect). We are gratified to be able to move our providers from an NPS of -15 to a +13 by end of a 2-week Sprint. And, the NPS for Sprint itself (how likely would you recommend Sprint to friends or colleagues?) was +54, which is up the range for Apple, Inc. We are in good company!

We also measured provider burnout on the Maslach Burnout Inventory scale. At baseline we found a 39% burnout rate, which decreased to 35% when measured within a month after completion of the 2-week sprint, a small but significant decrease. Importantly, providers told us “finally, someone cares!” “You made me a better mother! – I’m getting home to see my family.” and “I’m no longer going to retire because of EHR issues.” The rapid cycle improvements made a huge difference provider satisfaction.

From the great attendance at our session (standing-room only?!?), it seems there’s lots of interest also from many in the healthcare CIO community; and for that we are grateful for their feedback and conversation.

And, as with other talks I give, I ended with a song… enjoy!

CMIO’s take? Dance like no one can see you; Sing like no one’s listening.

Book Review: Worshipping the Myths of World War II


Four stars.

This book was written by a neighbor of a good friend, and our book club had the fortune of meeting the author to discuss his book, his life, and his insights into the world, that has changed so much in the past 70 years.

The myths he puts forth:

  1. The good war: is evil to abide the killing of innocents, by the nature of killing in World War II,
  2. The greatest generation: is disproved by the reality behind the war movie and novel. The generation that fought the war also helped defeat the hope for peace that swept the world at the end of World War II.
  3. We won World War II largely on our own: that the war would not have been one without our massive production of goods in material, our zeal for victory, in the battle skills and sacrifices of our troops. At the same time, we often tend to neglect the enormous contributions of other countries with a far longer war.
  4. When evil lies in others, war is the means to justice: Compromise and cooperation are always appeasement? Not true.

He dismantles each of these myths. He personally takes issue with books and movies of the War that sentimentalizes the war effort and that glorify battle. These myths we tell ourselves are harmful and set us and our future generations up for more bloodshed in the mistaken belief that War can be just.

CMIO’s take? We must resist our bloody ancestry, our hind-brain wiring and inclination to violent escalations of disagreement, and embrace the “better angels of our nature” (Lincoln). It is our collective cognitive power and creativity, not the artificial divides of geography, religion, resources, that define us and what we can achieve. The ease with which we can label and castigate the “other” is surprising.

I’ll still read books about war, I’ll still use and understand military references in strategy and tactics at work, I’ll probably see Dunkirk in theaters soon, but it will be with a different perspective.