As more patients email docs, health systems start charging fees (KFF Health News)

What’s the buzz about physicians and APP’s charging patients for online messages? This is a nicely balanced and informative article on the current state of health system billing for patient messages.

As More Patients Email Doctors, Health Systems Start Charging Fees

HERE IT IS! EMOJI’s Have Arrived in Epic Secure Chat

It is hard to express the excitement I have for this tiny little (yet disproportionately huge) development in our Unified Communications strategy

To those NOT on the Epic EHR journey, or those who have NOT been implementing “secure chat” tools in their organization, this may not seem like a big deal.

It is.

The challenge? Secure chat is terrific when you’re the sender, you can reach a LOT of colleagues by texting on your smartphone. HOWEVER, there is such a thing as “TOO MUCH OF A GOOD THING.” Some of our residents are receiving upwards of 400 secure chat interruptions PER DAY.

How can one even think, much less be effective as a physician / APP / resident caring for patients?

One of the unwanted interruptions is the expression of “Thank you!” when grateful for a rapid and effective response from a colleague. And YES, we do want to increase our mutual expression of gratitude to build trust and a sense of teamwork and human connection.

HOWEVER! This “Thank you” can come when the physician is scrubbed in to a surgical case, and we can’t tell when something is an new message or a “Thank you.”

One tool we have been begging our Epic Wisconsin developers for, is a NON-interruptive EMOJI that allows the reply with a THUMBS UP or SMILE or SURPRISE or CRY or HEART, that is NOT interruptive but shows up the next time that person checks their phone.

As a result? WIN-WIN! We give gratitude, feel a sense of connection AND the recipient does NOT receive another interruption, but can digest that reply at their leisure.

WELL, your wait is over, UCHealth colleagues, we have installed this Epic version update and now: HOVER OVER (on computer) or TAP AND HOLD (on phone) the message and you too, can send non-interruptive THANK YOU emoji’s.

Now, I’m going to go send our Epic Wisconsin colleagues an nice THUMBS UP.

Grok the Bones of a Good Story (a talk proposal for CHIME fall forum 2023)

Here’s a sneak peak at my newest talk. Did someone’s story defeat your data-driven brilliant proposal? Do you understand why? Like me, did you go crawl under a rock and wonder “wtf”? With luck, I’ll share this talk in November.

 

This is my proposal for CHIME fall forum. Storytelling for Leaders.

And recently given as a talk for UCSF’s Rehab Informatics Group.

If all the stars align, maybe I’ll see you in November?!

Science Communication Secrets (Wired.com, XKCD’s Randall Monroe on What If 2?)

Don’t think about it as if people aren’t smart. Think about it like people are busy.

From wired.com, Randall Monroe

https://www.wired.com/story/randall-munroe-is-back-to-answer-your-impossible-questions/

We scientists need to talk gooder. Randall is an excellent example of taking complex scientific ideas and making them understandable and relatable. I love his quote above:

“Don’t think of it like people aren’t smart. Think about it like people are busy.”

This is a paradigm shift for science (and all) writers: respect your audience. People know when they’re being talked down to.

This reminds me of one-page executive summaries to get your point across quickly.

CMIO’s take? Not only is Randall funny, see his http://xkcd.com comic series, but he is also insightful. Get his book, read his strip, its all good.

The rise of “BookTok”: 7 second emo sells books (nytimes)

Another sign of the times: older books getting a resurgence in sales from fans posting emotional reactions on TikTok.

Hmm. It seems that one can quickly change minds (and behavior!) on a population scale with super-short emotional appeal.

The good: Shows that Daniel Kahneman’s “Thinking, Fast and Slow” is an important pillar of modern online technology: emotions and story change more minds than just data. (link is to a blog post on The Undoing Project about Kahneman’s life and work).

The bad: Shows that Nicholas Carr’s book “The Shallows: what the internet is doing to our brains” is also right — we don’t have patience to read long-form fiction, except maybe when TikTok tells us to. (link to my mindfulness blog series, and a review of Carr’s book).

How ironic.

Sag A*: here’s a photo of the black hole at the center of our Milky Way (NYtimes, NASA)

We live in astounding times. Read the article and more importantly, see and hear the excitement of the scientists giving the press conference. So proud to be human right now!

The Pyramid of Possibility: explaining informatics to others

Use this to explain to your colleagues that some requests are easy and others might just be impossible.

Have you ever been asked by a colleague: “Hey, wouldn’t it be great if Epic could just do ___ ?”

Some recent examples from my life:

  • Show me my last progress note so I don’t have to hunt for it (Yes, it does that, right here in the Story Board, I can show you in 2 minutes).
  • Find all the open appointments to put a patient into a provider’s schedule, quickly at a glance (Yes, Epic top tool bar: Provider Calendar does that)
  • Remind me of the pre-op scrub protocol (Yes, we can build that into an order set but you have to develop consensus, that will take YOU weeks of discussion)
  • Fund a Sprint EHR optimization team to teach everyone efficient work tools (sure, took me 2 years of convincing leadership to invest in a Sprint team)
  • I want to bill insurance for responding to online messages WITHOUT a co-pay (Welllll, you’ll need to change Federal and Medicare rules, so that will be YEARS TO NEVER).

Yes, we know our colleagues have great ideas and they’re well intentioned, but only IT and informatics people have a sense of what it will REALLY TAKE. So, I made this pyramid to show people, examples of how an tiny, itty-bitty, innocent request can turn out to be nearly nothing or an ENORMOUS MONSTER.

https://www.dropbox.com/s/b6a7dn1hix5kf6j/2022%20EHR%20Pyramid%20of%20Possibility%20CTL.pdf?dl=0

CMIO’s take? Hope you like it and maybe find it useful. Did you make a better version? Let me know!

This video about storytelling will change your life

I have followed Andy Goodman’s work (he teaches storytelling to nonprofit organizations), and have learned so much about how to be effective at my own work.

It is nearly an hour long, and who has an hour? You do, if you know what is good for you.

But, I know you’re busy, so, if nothing else, watch at 10:30 minutes for 7 minutes. It will be the best 7 minutes.

Then, since you’ll be hooked by then, watch the whole thing. You won’t regret it.

No one ever made a decision because of a number. They need a story.

Daniel Kahneman, in Thinking, Fast and Slow

CMIO’s take? Storytelling by masters like this change lives. He did mine.

What TikTok teaches us about effective communication

Those of us stuck in the “last century” take heed: TikTok and 15 to 60 second videos are IN.

 

My Tiktok channel: https://www.tiktok.com/@ctlin99

The TL;DR? 15 seconds should be the length of your educational videos. Wanna know why? and how? read on.

I was a Late adopter of Facebook

I’ve been thinking about the evolution of social media. In early days, I was a late adopter of Facebook, not getting why it was any better than email. Now, I get it: saying something once allows your network to see it, from close friends, to casual acquaintances. Medical residents explained to me that photos and memories were easier to share more broadly. AND, an existing large network made participation more valuable (hey! look at all the people I already know on here!).

Just like in the old days, getting a telephone was INCREASINGLY useful if there were MORE people and stores you could call. The network effect.

LinkedIn, Twitter

That led me over the years to LinkedIn (mostly for work contacts and posting my CV and work products publicly) and Twitter (still figuring it out, but a good way to keep up with news if you curate your network carefully, and also a way to post blog content). Also, Twitter allows you to curate for yourself an international community with similar interests, like #medtwitter.

And, my brilliant younger sister taught me that Twitter could also be good for lecture commentary and discussion (she will give a talk on 2 screens: one with her slides and another with a live pre-filtered Twitter feed: how brave! and give out a custom hashtag, like #postitpearls_lecture, and ask the audience to submit questions this way: wow).

YouTube

And, some of you know that I’ve dabbled in amateur song-parodies with EHR songs on my youtube channel.

IFTTT, blogging

Finally, I’ve figured out how to blog regularly and then use IFTTT to cross-post my content auto-magically to my other platforms (Facebook page, Twitter, LinkedIn) so that I can seem more connected and omni-present than I really am (Thanks for another great tip, Sis).

Tiktok?

BUT! TikTok is another thing altogether. My colleague and her daughter suggested that I take my latest Hamilton parody song (that I had gamely posted to YouTube and here I am shamelessly showing it to you again)

#notthrowinawaymyshot and now post it on TikTok, a post-millenial social media platform restricted to 60 second videos. Leaving aside the recent kerfuffle about Chinese ownership and control, this is qualitatively a different animal: getting your thoughts across in 15 seconds (preferred duration, and the time restriction being a result of the music industry’s maximum replay length of a copyrighted song). It has since been extended to 60 second maximum if you have an original soundtrack on your video.

So, I dove in. Unlike my “dozens” of views on my YouTube channel (with which I was satisfied; my broadcast domain is, admittedly to a relatively small physician informatics audience), my TikToks quickly blossomed to nearly 1000 views in 2 days.

Wow! I thought. I am AMAZING on TikTok.

What I did not appreciate is the 15 to 60 second format is much more attuned to the rapid “swipe” of post-millenials, and EVERYONE racks up lots of views. And, ultra-short videos are so easy to consume one after the other. AND, TikTok doesn’t need you to establish your network before your video gets out there; it shows your video to a random selection of viewers, and then those who LIKE it or SUBSCRIBE to you trigger the algorithm to show it to more viewers. So, an easy way to game the system is to use trending (but highly inaccurate) hashtags, like #superbowl, etc. Sadly, this user does not seem to have understood, or be willing to follow, some of these informal rules.

Furthermore, if you read online chatter about TikTok views “500 views total, is pretty sad; what you want is 500 views per hour.” For example, Nathan Evans, of Sea Shanty fame? He went viral at about 250,000 views, and now he’s at 12.9 million. Oh, well. Here’s my paltry Covid Sea Shanty, currently at 62 views (not 62,000) and SIX LIKES.

In contrast, our Informatics team at UCHealth just retired/deleted a 17-minute video I made a 10 years ago for a full “walkthrough” of how to use the Electronic Health Record for our ambulatory clinic physicians. Whew, how out of touch was THIS guy? Here’s a one minute snippet of the kind of video I posted back then, when we were on Allscripts Touchworks. So young, so naive.

Our more recent training videos are more like 1-2 minutes and focused on ONE technique or tool. Now, I’m thinking, maybe we need to shoot for 15-30 seconds. The cool thing about TikToks is that you can trim seconds, speed things up, because those viewers who “get it” can be done watching in 15 seconds, but the video can be paused and also it automatically replays so the viewer can catch subtle details. Hmm, is this a paradigm shift? Should we embed TikTok length education videos into our EHR?

Put Road Signs On the Roadway

As we say internally, shouldn’t we put the Road Signs and Driving Directions (our tips and tricks) on the Roadway (where our users are actually using the EHR) and not in the Garage (our online reference library and training webinars)? Aren’t our users more likely to click on tips WHEN they’re doing work, rather than when “oh, I have some time, let me see what I can go learn.” (which is never)

Austin Chang is my hero

There clearly is an entire evolution of thinking needed to succeed in this TikTok medium. And I don’t have the savvy (yet), the luck, or the persistence to grind out the many tries needed to break through. However, there are medical professionals who have. For example, Austin Chang.

Austin is … well, just go watch him. In 15 seconds, with hilarious music over-dubs, he uses captions and terrible dancing while in scrubs (ok not so terrible), to get his medical facts out there.

I both bemoan the general public’s deterioration of attention span (15 seconds now? Really?) and his ability to fit his tiny education bites (bytes?) into this format. It works. Some of his TikToks are over 2 million views. On MEDICAL TOPICS. Nice. Here’s the NYTimes writing about him.

This reminds me of reading The Shallows, a book about what the Internet is doing to our brains. Are we losing the ability to read a book? I don’t know. I, for one, did not finish reading the book. Ironic.

CMIO’s take: Beat ’em or Join ’em? What are YOU doing about TikTok in your field?

The most effective way to approach the vaccine-hesitant

From Haymarket marketing communications website MM+M

https://www.mmm-online.com/home/podcasts/the-mmm-podcast-6-24-21-zss-jacob-braude

This is a 28 minute podcast. The crucial moment (for me) is about 12:30.

Of the all the psychologies and tactics to address various subpopulations of the vaccine hesitate (for pediatrics, for adults, for COVID in particular), ONE tactic was most effective across all these subpopulations, use of “confirmation bias” as a tactic.

If you’re in a conversation about the vaccine, leave aside all the data and arguments.

Often we see people trying to persuade by saying ‘OK, here are the facts. Here’s why you should get vaccinated,’ ” Braude said. “But this research says actually what you should ask is ‘OK, why would someone want to get vaccinated?’ and have them go through the process in their own words. That works much better than the persuasion techniques we see people trying to use.

It turns out that 20-44% of people who answered this question, who were asked to TAKE THE EMPATHIC STEP of putting themselves in the shoes of someone wanting to be vaccinated, and then having to describe the reasons why, ended up changing their mind and agreeing to get vaccinated.

Huh. I think I have never done that. Time to learn and use something new.

CMIO’s take? There are so many interesting facets of the human mind. Even amongst physicians and healthcare workers, we have a lot to learn about how humans think, and how we make decisions. We need to harness this for the public good. Who is with me?

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