You’ve been choosing your goals all wrong (Wired)

Yup, what were you thinking? Don’t you know each goal cascades into multiple sub-goals, and pretty soon, you’re drowning? So what is the solution?

Photo of author’s son, from our visual travelogue as we hiked The Narrows in Zion Canyon a couple years ago.

https://www.wired.com/story/how-to-choose-better-habits-goals-psychology/

CMIO’s take? Set a goal (not multiple goals: ONE), and have the discipline to choose a daily habit to support it. Set it SMALL. No, smaller than that. And then stick to it. Yes, let’s both try it.

“That’s a waxing gibbous. That means it’s going to get bigger” (NYTimes)

‘Luddite’ Teens Don’t Want Your Likes. When the only thing better than a flip phone is no phone at all.

From Scott Rossi for the NYTimes

Luddite Teens Don’t Want Your Likes

This is a fascinating throwback to the Luddite Movement where workers rebelled against the new machinery.

This is teens taking back their lives from the pressures of social media.

I think we could all learn something from these teens. Yes, I realize I’m a CMIO.

How to Think Outside Your Brain (NYTimes.com)

 

This is awesome in several ways (read the article, link above).

  1. Having a “creative desk” full of glue, scissors, sticky notes, colored pens is always better when designing something. Once done, you can move to your computer and finish it at your “publishing desk”. This research tells you why (you can think outside your brain using your body and your physical space)
  2. The EHR (electronic health record) is a way to help your brain think, if we do it right. Do we do it right? This is “using tools” to augment our thinking.
  3. Then we have “other people’s minds” with the hint that teams who know how to draw on complementary skills from others in a team, perform better than individuals or uncoordinated teams. What does that teach us about our informatics work?

I will have to sit with this article for awhile. What are you taking away from it?

My Gratitude Letter (to Dr. Fred Platt), and why you should write one too

Learning to write a gratitude letter is worthy exercise, for both the writer and the recipient. There are surprises here …

In our wellness work, we learn surprising things about ourselves.

First, that expressing gratitude benefits both the giver and the recipient, in terms of mood and overall health.

Best of all, giving gratitude, unlike carefully wrapped, commercially-obtained holiday gifts, is FREE.

One particular activity worth noting, is the GRATITUDE LETTER.
Here’s how to do it.
Write a letter to someone for whom you are grateful, and tell them why.
Make an appointment to see them in person.
Read the letter out loud to them.

The research tells us that both the giver and recipient receive a months-long boost in mood from that event.

WHY DO WE NOT DO THIS ALL THE TIME?!

Reader, I did this last week. I’m here to tell you how it went. One of my mentors is Dr. Fred Platt, author of many peer-reviewed articles and books on Physician-Patient Communication: Field Guide to the Difficult Patient Interview, and the Annals of Internal Medicine’s Words that Matter series, including “Let me see if I have this right …“. In later years, he wrote poetry.

He helped me get started in academic medicine, in teaching medical students, in learning how to be an excellent communicator, in being a better doctor, a better colleague, a better human being.

Now, decades later, his health declining, I wrote him a letter, made an appointment, and drove to see him. He only had the energy for a 30-minute visit, but loved the letter enough to have his wife and I read it to him twice.

Not a dry eye in the house.

I will miss you, Dr. Platt. Thank you.


November, 2022

Dear Fred

Thank you for the chance to tell you how you’ve changed my life.

I met you at the Bayer Institute CPC Workshop: Clinician-Patient Communication to Improve Health Outcomes. You facilitated a group of 16 junior faculty in Internal Medicine in 1997, and taught me, among other things, Reflective Listening: “So, it sounds like you’re having some belly pain, and it is going down to the right side, and you think it is … gout? Do I have that right?”

I learned about Ideas, Feelings and Values, and it changed my life. I became a Bayer-certified Communications Facilitator to follow your footsteps.

You took me under your wing, you re-ignited my passion for patient care, and gently taught me tools for difficult conversations: “On the one hand you think … On the other hand I worry …”

You co-founded Foundations of Doctoring at University of Colorado. Our initial trials at teaching communication in lecture halls met with abject failure. 160 students at the first lecture, and only 5 come to the second one.

We repeatedly redesigned the course until it really sang: 1 standardized patient, 4 student learners coaching each other, and a facilitator guiding ILS: Invite, Listen, Summarize. I use and teach these tools today to incoming students.

You generously asked me to co-author numerous communications papers, published in several journals, including the series WORDS THAT MATTER in the Annals of Internal Medicine. We discussed a number of delightful cases, including the case of the patient who ate too many pies at work, and wanted to claim workman’s compensation, prompting an outburst from my resident.

For this computer-geek doctor, you taught me compassion and connection and relationship-building. These are my guiding principles to this day. In my national travels and talks that I give in the Informatics world, there are few who have had a mentor like you.

I am proud to teach your ideas that words matter, communication matters, relationships matter.

I’ve learned over the years, that I have an internal Judge voice, who sounds suspiciously like my father, and an internal Sage voice, who I call Fred.

I am so grateful for your teaching, your counsel, your collegiality, and your friendship.

Thank you, Fred.

With Love
CT Lin
Chief Medical Information Officer, UCHealth
Professor of Medicine, University of Colorado

 

CMIO teahouse menu

How can tea improve clinical decision support? How does it help change organizations? Are you kidding?

Links to some of these teas:

CMIO’s take? Those of you who have worked with me know that one of my favorite things is to have 1:1 meetings in my office and serve tea. Taking inspiration from my spouse who enjoys throwing cocktail parties and creating a fanciful drink menu, I recently put together a CMIO’s teahouse menu. I hope you enjoy it.

“The useful part of a pot is where there is no pot” -Audrey Tang, Digital Minister of Taiwan

Hollowed out
clay makes a pot.
Where the pot’s not
Is where its useful.

Poem 11

Thirty spokes
meet in a hub.
Where the wheel isn’t
Is where it is useful.

Hollowed out
clay makes a pot.
Where the pot’s not
Is where its useful.

Cut doors and windows
to make a room.
Where the room isn’t,
there room for you.

So the profit in what is
is in the use of what isn’t.

Taken from Ursula LeGuin’s version of the Tao Te Ching

https://www.wired.com/video/watch/wired25-2020-audrey-tang-taiwan-covid-19-pandemic

Watch this video/ read the transcript. I love this for several reasons:

  • The Taiwanese are my people
  • “Digital Minister” is the best title of all time
  • Taiwan’s national response to COVID is a model for the world (Taiwan: fewer than 1 death per 100,000 vs USA: 66 deaths per 100,000)
  • The transparency of information and the building of trust: the government published its COVID and mask data with open API’s so private industry and nonprofits could build 100’s of apps to improve healthcare and the commonwealth
  • The POETRY of Taoism!

CMIO’s take? It is worth a watch. Informatics applied effectively at the national level. And, bonus: mindful Taoist philosophy applied to transparency of information. Zowie!

Epic EHR webinar with UCHealth: Inbasket Re-invention: did we really delete 12 million messages?

Yes. Yes, we did.

https://userweb.epic.com/Webinar/View/7968/Taming-the-In-Basket-with-UCHealth-Teaching-an-Old-Dog-New-T/

Are you and your organization struggling with:

  • How to tackle the hyperobject that is the EHR inbasket?
  • Does your legal/compliance team worry that deleting messages is bad idea?
  • Do you have users with tens of thousands of unread inbasket messages?
  • Are you having trouble getting starting on this ambiguous, massive effort?
  • Would you like to know some of the specific settings and decisions we made?
  • Are you concerned that it is difficult to measure improvement with inbasket?
  • Are you eager to see CT Lin and team fail at yet another ambitious but ill-fated project?

If so, you =might= find some answers in our recorded discussion above.

We touch on: leadership, governance, organizational change, legal concerns, specific Epic EHR inbasket settings and decisions, clinician burnout, high-performing teamwork, and human connection. Really.

Note: Hosted by Epic. Login to Epic Userweb required. Go watch it, then come back and tell me what you REALLY think.

Here’s your moment of zen – cactus images from Arizona

Here is the “burr in my sock” or “pebble in my shoe” that bad EHR design can become. In another context, this is can be beautiful.

Found this in my sock in the middle of my hike.

The only way to hike in Tucson in the fall is starting at 630am and being done before 9am.

CMIO’s take? Be present, get outside, take a breath.