Dr. CT Lin’s Covid-19 advice for patients. KOSI 101 and Mile Hi Magazine

In the link below, it is the interview from April 12, 2020.

https://kosi101.com/mile-high-magazine-public-affairs/

I had the pleasure of being interviewed by Mile Hi Magazine last week in regards to questions about how patients can cope with Covid-19 at home.

I responded to such questions as:

  • So many people contract but recover, is this what our body is designed to do?
  • Can people determine whether they have the virus without a test on symptoms alone?
  • When contracted, quarantine is the first step. What’s next in terms for two weeks – nutrition, special foods to eat to help the immune system fight?
  • Any special foods we should be eating now to be in top immune condition should we contract?
  • Any over-the-counter medicine to take for the fever or diarrhea?
  • Should people change out bed linen during the two-three weeks period?
  • Once fever breaks, is this a key sign that its over?
  • Should people exercise while body is fighting the infection?
  • Once over, should person we wait a couple days to ensure no symptoms return?
  • If Covid-19 is a flu strain, will it mutate into another strain as flu does each season for next winter?
  • Anything else you feel is pertinent to help people feel they can get over it if infected.

I made one particular point at the end of the interview. I shared our family’s strategy for coping with the anxiety and stress during this pandemic:

  1. Exercise every day
  2. Play or make music every day
  3. Limit yourself to 30 minutes of news or social media daily
  4. Three Good Things. At dinner each of us discusses THREE THINGS we are grateful for, today. INSTEAD of our natural tendency to focus on the negative, this exercise helps us reframe our day in a positive light.

CMIO’s take? I challenge all of us to do THREE GOOD THINGS with our loved ones at dinner every night.

UCHealth: ‘Most Wired’ level 10!

Uncomfortable-looking author

We are incredibly honored and humbled to be awarded Most Wired level 10 by CHIME: the College of Healthcare Information Management Executives.

We were one of the three organizations, out of thousands applying, to be awarded level 10, indicating the highest achievement in superior performance and process for information technology used to improve clinical care. This is the first year that CHIME separated out the awardees into levels 7, 8, 9, and 10.

See my last blog post for some of the details of our presentation at CHIME and some of the projects contributing to our success.

It was humbling to stand by the CIOs from Cedar Sinai and Avera Health to receive the honor. Link to article from CHIME below.

CHIME Posts 2019 Most Wired’s Awards and Recognition List

What I said in my acceptance comments, and I stand by them:

At UCHealth, Clinical and IT excellence arises from Partnerships:
1. Partnership between the CIO and CMIO and our teams. We make each other better than we could be alone.
2. Partnerships between UCHealth and our vendor partners: we know that there are more smart people who DON’T work for us, than who do.
3. Partnerships between UCHealth and the CHIME community. Healthcare CIO’s are a brilliant lot. We know we stand on the shoulders of giants.
Lastly, we want to pay it forward. More than 3 health systems deserve to be level 10. ALL patients deserve to be treated by a health system performing at its best and we want to see MANY MORE health systems on stage next year.

The End of Secrecy? (a preview of a talk at CHIME19)

I’m at CHIME19 this week: the College of Health Information Management Executives, Fall Forum. Eight hundred Healthcare CIO’s and a growing number of CMIO’s are members. My CIO, Steve Hess and I are giving a talk called “Is this the End of Secrecy in Healthcare?” where we outline our (sometimes) rocky journey toward ever-increasing transparency for our patients.

We know that an informed patient is much more likely to be an engaged patient, and engaged patients have better health outcomes. So, how do we increase the information available to patients? We have to overcome inertia, fear, and sometimes, epithets.

We were interviewed by Kate Gamble of Health System CIO to preview the contents of our talk, see below.

https://healthsystemcio.com/2019/11/01/how-uchealth-is-leveraging-transparency-to-create-a-better-user-experience/

Sometimes we have to look outside of healthcare for our inspiration:

  • OpenTable
  • Travelocity
  • Wikipedia
  • Instagram
  • Yelp
  • 23andMe

Confused? Excited? Freaked out? So were we.

CMIO’s take? Is this the End of Secrecy? Yes. Yes it is.

Making slides for a talk? How to make them more memorable (advanced tips)

Powerpoint deck on how to give a good powerpoint talk linked here: https://www.dropbox.com/s/pmzloklxmmr5132/2019-0513%20How%20to%20give%20an%20effective%20presentation%20-%20advanced%20-%20CTLin.pptx?dl=0

I’ve been thinking about giving talks backed by powerpoints. Leaving aside the many talks on “Death by Powerpoint”, the lifeblood of the industry is on slides-man-ship in presenting new ideas to our own organization’s leadership, and at national meetings.

And then you see these lovely presentations by TED speakers who are inspiring, tell great stories, but DO NOT have to provide detailed scientific rigor underneath their high-flying narratives.

We, in informatics, have to contend with both parts of this conundrum: how to tell a compelling story well enough to capture imaginations, and more importantly, purse-strings, and yet back it with enough data and science to be compelling to our very picky bean-counters and scientists.

Further complicating this fact is that often, our powerpoints get distributed by email and have to STAND ALONE to convince others, sometimes. Therefore, the whole TED TALK, with IMAGES ONLY and NO DATA become useless in this context; now we have to figure out EITHER how to write an entire white paper (1-4 page brief that can be read quickly) to supplement any slides we give, or to modify these slides so that they CAN stand alone. Ideally, we can write a powerpoint slide deck that includes enough detail to satisfy data-hounds, and yet engaging enough, with a minimum of words, to create a compelling narrative.

CMIO’s take? Only you can judge if I’ve achieved my goals (see link). This is a summarization of more than a decade of my ‘doing it wrong’ and set of guiding principles that I’ve used to continually improve my own talks. I already presume that you know how to build a Powerpoint deck, and that you’ve read other articles on How-To in powerpoint, maybe Garr Reynolds’ Presentation Zen, or Dan Roam’s Show and Tell. There’s lots out there. But this is my take.

Improving Wellness via EHR Optimization Sprints and High Performing Teams. WellDOM speaker series with Amber Sieja and Katie Morrison

It is always a pleasure to stand up and discuss our Informatics work in public forum. We always strive to reduce physician burnout and the EHR burden by improving teamwork and practice efficiency. As a side effect, we discovered the principles behind Agile teamwork, reducing waste, and the ideas underlying High Performance Teams (both running one, and teaching clinics how to become one).

The talk is 50 minutes and the podium is shared with my colleague Katie Morrison MD, Director of the WellDOM program (Wellness in the Department of Medicine at University of Colorado) and my colleague Amber Sieja MD, Senior Medical Director of Informatics at UCHealth. I’m grateful for their brilliance and collaboration.

The TL;DR is:

  • Sometimes you have to borrow and steal a team to get started
  • Get the right people on the bus: a physician informaticist, nurse informaticist, project manager all are crucial
  • EHR efficiency is NOT only about physicians: it is about teamwork
  • 2-week Sprints are a good timeline: short enough to be urgent, long enough to make some real change in the clinic
  • Eventually you’ll discover Agile, Lean, High Performance Team principles. Live them, and teach them to sustain yourselves

CMIO’s Take? TL;DR. Just do it.

“Empty Wallet” or Real Time Benefits Check interfaced into the EHR (woo!) Ukulele

Yet another misadventure with our protagonist

Thanks to all our EHR colleagues; I’m returning from Epic’s UGM (User Group Meeting: check out the twitter-verse at #UGM19) and learned a ton from other customer presentations and from Epic’s future vision as a company. Here is our contribution: a successful integration of RTBC (real time benefits check) of prescription co-pay, prior authorization data, and “payer suggested alternative” meds, right in the prescriber’s workflow, right inside the EHR. Simple, works fast (pharmacy- and patient’s insurance-specific real-time check within about 1 second) for every prescription written. Now, you can tell the patient “This prescription has a $4 co-pay at Target pharmacy”. What a difference.

This was the difference between my patient NOT paying $291 for doxycycline tablets vs $90 for doxycyline capsules. Really?

See my blog post on RxRevu previously. This is working well, and we’ve scaled up to all 3000 prescribers at UCHealth with excellent results.

TO celebrate, we’ve come to discuss our success at UGM … and (of course) to sing a song. Thanks to Terri Couts, VP of Epic Applications at Guthrie Clinic, co-presenting the topic, and for agreeing to sing with me!

CMIO’s take? Enjoy the song.

I Can See Clearly That My Sprain is Gone – Ukulele parody (and an XGM talk)

Author along with co-conspirator Peter Sachs MD. Neither can sing.

We (Dr. Peter Sachs, Vice Chair of Radiology at UCHealth, and I) recently had the pleasure of presenting our recent quality improvement work at Epic’s XGM (eXpert’s Group Meeting) in Verona, WI this week. In brief, we created and turned on the ability for patients to view their own radiology IMAGES online in their patient portal. We had already been sharing radiology REPORTS with our patients for over a decade, and this is an additional step towards information transparency. We think we are among the first to do this.

Despite some minor misgivings on the part of our clinical leaders, we were given the green light to turn this on. Short answer, over 22,000 patients viewed their images in the first month, September 2018 and … no complaints from either doctors or patients! So, we get to keep our jobs!

If you have 2 minutes, here’s the song:

And, if you have another 25 minutes, here’s the talk, and some Q/A after:

Patients Viewing Their Radiology Images Online. Peter Sachs, CT Lin, XGM 2019

CMIO’s take? It is terrific to have a close community of like-minded physician informaticists and technologists pulling to improve healthcare and patient experience, and celebrating each other’s successes. I’m ever grateful to innovative and inspiring colleagues.

What is a Yottabyte, and How Do You Treat It? (a talk)

I gave a keynote speech late last year at Technology Awareness Day, hosted by the University of Colorado, Anschutz Medical Campus about Big Data, Tech acceleration, and Artificial Intelligence, as applied to healthcare.

I enjoy making my colleagues uncomfortable. How long will doctors have jobs? Will the AI eliminate internal medicine doctors? If Watson can beat humans at Jeopardy, can it beat me at reading medical literature? Can it be dermatologists at diagnosing skin cancer? Can it beat radiologists at interpreting CT scan images?

It is true that the most complex object known to us is the human brain, with its trillions of neurons and extensive interconnections. From this physical matter, something called “general adaptive intelligence” and “consciousness” arises, neither of which we understand or know how to construct or deconstruct. On the other hand, fundamentally though, isn’t a neuron a collection of physical and chemical processes that we DO understand? And then extrapolating upward then, is it not conceivable that we could eventually figure out how to construct a human brain in all its complexity? Hmm.

Reading books like “Life 3.0” and “Superintelligence” gets me thinking about stuff like this. It is both humbling and exciting at the same time.

CMIO’s take? Decide for yourself. I know, it is almost an hour long, and who has an hour anymore, especially if TED speakers can get their point across in 10 minutes? Well, consider my talk a series of 4-5 TED talks. Yeah, that’s it.

Dept of Medicine Innovation talk (video) on EHR Sprints

img_2238
I play a doctor in this blog, and sometimes in real life. 

http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/Pages/RIC-09-20-2018-Lin.aspx

Recently I gave a talk for the Department of Medicine Innovation and Research seminars at the Anschutz Medical Campus for University of Colorado’s School of Medicine. I spoke about one of my favorite topics, some of which I have discussed in these blog pages: Reducing the EHR burden and improving physician burnout with EHR Sprints.

CMIO’s take: what is YOUR organization doing to address physician burnout? Something similar? Let me know!

We are Physician Builders (ukulele EHR parody)

Here we are at #ugm2018 Epic’s annual User Group Meeting. We’re at our first Directors’ Advisory Council session with over 600 attendees, and we discussed our governance approach to Physician Builders and how we overcame internal resistance to the idea that Physicians could do a good job creating new designs, templates, smart tools, and other content (and some actual programming) in the Electronic Health Record (they can!). In fact, our 19 Physicians who are now certified builders have made substantial improvements to our EHR environment on behalf of numerous medical and surgical specialties, as well as our physician users in general.

The point being, that although IT analysts are terrific for creating most of the content of the EHR, having physician builders with deep knowledge of the EHR technology leads to some interesting capabilities:

  1. Physician informaticists, with clinical knowledge, strong communication skills, and now technical know-how, can help other physicians reduce the EHR burden by matching tools to the clinical scenario, and reduce cognitive burden. For example, it is difficult to order the right cardiac arrhythmia monitoring tool (Holter? Event Monitor? Zio? Some other device?). Instead of building what a cardiologist physician was requesting, our physician builder thought about it, and suggested some the creation of a cascading order panel that gently guides the ordering physician to the right order WITHOUT building an exhaustive long checklist with difficult-to-follow paragraphs of instructions. Having a foot in both worlds is beneficial in this case.
  2. It is delicate and important do develop EXCELLENT relationships, CLEAR communication and strong guidelines so that the IT analyst team and the physician builders know what to expect from each other. When done poorly, turf battles erupt: “don’t touch those tools that I built!” But, done well, we become a synergistic team: “wow, thanks for taking on those Express Lanes; we would not have achieved our Honor Roll status (and helped all those urgent care centers) without your help.”

Really proud of our high functioning team.

And to ensure our audience got the point, we sang them our song. Lyrics below, YouTube link above.

We’re Physician Builders (Champions, Queen)

I’m a frustrated doc. Am Em
Passed my builder test
I wanna build
But she says: ‘You jest!’

And bad mistakes. C F
I’ve made a few
I’ve had my share of bad code kicked in my face C G Am
But I’ve come through! D7 G A

We’re physician builders, my friend D F#m Bm G A
And we’ll keep on buildin’ ’til the end D F#m G A
We’re physician builders, we are the builders Em A7 Gm A7
Those are happy users, cause we are the builders D C F G7
Of an Epic world. G7 D

I’ve set up smartlists. Am Em
And CER rules
You sent us Foundation and everything that GOES w it
I love those smart tools.

And maybe with time C F
Create a team goal,
We’ll share build in Text and Hyperspace
And make Honor Roll! C G Am D7 G A

We’re physician builders, my friend. D F#m Bm G A
And we’ll keep on buildin’ ’til the end. D F#m G A
We’re physician builders, we are the builders Em A7 Gm A7
Those are happy users, cause we are the builders
Of an Epic world.  D C Bb G7 D

CMIO’s take? What are YOU doing to ensure that you don’t take yourself too seriously? Are you here at Epic #ugm2018? Let me know!