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. 

Mobile Stroke Unit, 4th in the country

Cool Stuff Ahead!

Our Neurosciences and Stroke team worked with our telehealth program, bought a souped-up ambulance, installed a portable (PORTABLE!) CT scanner, and now we can send this ambulance out on any 911 call that sounds like it may be an early stroke.

Unlike current state-of-the-art facilities that take 30-60 minutes AFTER the patient arrives in the Emergency Department to diagnose a stroke, rule-out a bleed, and administer tPA, the clot-busting drug (so called “door-to-needle time”), we now have NEGATIVE door-to-needle times.

In other words, we’re driving to the patient, performing the CT scan IN THEIR DRIVEWAY at home, transmitting images to our neuro-radiologist, using a 2 way video link between neurologist and patient, finalizing a diagnosis, and administering life-saving tPA right there in the driveway. BOOM. “Needle” time occurs before “door” time. Watch the video link above for details. So proud of our teams and the technology we develop to support outstanding patient care.

NYtimes: releasing medical records

08up-records-superjumbo-v2I’m gratified that the public conversation on electronic (and also paper) medical records continues. Its a dry topic, but oh so important. Ms. Sanger-Katz writes about Casey Quinlan (and her QR code!), and the difficulty of assembling a longitudinal health record that becomes more important as we get older. The morass of privacy, mistrust, bureaucracy, swiss-cheese implementation of EHR (electronic health records) with few electronic connections, throw numerous barriers into this journey. Open Notes is just the opening salvo in trying to ease that journey.

Those who succeed in pulling together their medical records to coordinate their care are lucky indeed:

Dr. Tierney worked for years in Indiana to help the state develop a cutting-edge health information exchange, a place where most of the state’s hospitals shared patients’ medical data. After 44 years in the state, he queried the exchange for his records before leaving. He paid $100 for an inch-and-a-half-thick stack of papers.

“I went to my new doctor,” he said. “I put it on the table. And she said, fill out the form.”

www.nytimes.com/2016/09/08/upshot/release-your-medical-records-first-you-must-collect-them.html

Open Notes: a 16 year journey

Upcoming press release:

UCHealth is excited to be the first in the state of Colorado to offer Open Notes to all 1.5 million patients in our system (as of May 2016). Open notes are now available across the spectrum of care, including outpatient clinics and emergency department notes to hospital discharge summaries. We believe that information transparency is crucial; an informed and engaged patient is a healthier patient.

Or, in Haiku form:
Not sure what Doc said?
Why hide medical advice?
Open Notes are here.

Medicine in the age of Facebook #iHT2

My talk at the Institute for Healthcare Technology Transformation today, as covered by Mark Hagland of Healthcare Informatics journal:

Article at:

http://www.healthcare-informatics.com/article/patient-engagement/it-s-transparency-get-over-it-ct-lin-md-challenges-iht2-denver-audience

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