The Premonition – Michael Lewis: not the pandemic story you think it is.

from Amazon.com

When my book club decided to read “The Premonition” and I found out it was about the pandemic, I discovered that I was TIRED OF READING ABOUT THE PANDEMIC.

But, I underestimated Michael Lewis’s skill as a storyteller. I guarantee that you have not heard these stories. Not about Dr. Charity Dean, Santa Barbara County’s Public Health Officer. Not about the Wolverines, a shadow organization comprised of current and former federal government employees connecting resources and brainstorming ideas. Not about the fundamental structural problems and failures with the CDC since 1976.

I was entranced and raced through this book. It was complementary to the things I thought knew about the pandemic, having just lived through it.

The CDC does not come out smelling like roses. Neither do most federal agencies with political appointments. And Lewis dives into it incisively, following these personal tales where they lead.

He ends with a hopeful note, that Dr. Dean has left public service to found a private sector company called “The Public Health Company.” Maybe if the feds, our public health infrastructure, and the CDC cannot act effectively, those who DID act effectively in 2020 can become a consulting firm to private industry (there is immediate demand among large international companies for such services, advice and protection) and eventually support the federal government if we do not fix our pandemic responsiveness, when the next pandemic (and yes, it is coming) arrives.

CMIO’s take? I have new respect for public health officers. I have new respect for the CDC prior to 1976 and hope that this book points us to lessons on how to re-invigorate our federal institutions, and make them effective again. This is very readable, and worth your read.

Intersection of Robotics and K-pop

from hyundai.com via wired.com

https://www.wired.com/story/boston-dynamics-bts-spots-on-it/

I love when robotic engineering cross-fertilizes with art and dance, as in this mash-up.

I’ve mentioned before that my son has his own youtube channel, as, during the pandemic he and his sister got into K-pop, learned some dances from BTS and others, and now Mom and Dad are also nascent K-pop (and K-drama!) fans. Heck, even PBS has gotten into explaining the nuances of K-pop (9 min Youtube).

On the other hand, I’m always interested in taking science and engineering ideas and making them more accessible, more beautiful, more elegant.

Here’s Boston Dynamics’ Robot(s) SPOT dancing to IONIQ from BTS. Enjoy.

Covid Vax Status, and Our Mental Health Status

We have a monthly Epic Provider Newsletter where we share system updates, and I send CMIO Update paragraph to my colleagues. Here is my update for this month:

With our next Epic system upgrade this week, Covid Vaccine status is now in the patient Storyboard! This is HUGE. It is now instantly visible when opening the chart, if/when the patient was vaccinated. This should help with rapid patient assessments and counseling, since the Covid-19 Pandemic Crisis now morphs into Covid-19 Ongoing Management. Possible Vaccine Statuses include:

  • Unknown (instead of ‘unvaccinated’ we know lots of vaccinations are not in our system; this prompts us to ask)
  • Dose 1 complete (if a 2 dose vaccine)
  • Dose 2 overdue (if late for second)
  • Vaccinated (XX date) if within last 2 weeks
  • Vaccinated

This is a nice improvement in our EHR.

IN PARALLEL, in discussions with colleagues this week, there is a sense that we are emerging from the pandemic. However, the prevalent emotion is not necessarily “relief”. Some say that they feel a sense of PTSD, or symptoms of exhaustion. In my mind, I feel like we have just finished running a sprint and are ready to stop and lie down.

BUT NO, there is no time take a break, it is time to resume the marathon of our regular healthcare jobs. 

We spent the last 15 months putting aside our burnout, putting aside our lives, and putting EVERYTHING into fighting this crisis, hoping to extinguish it.

Now, we put down our crisis tools, and look up and see … no end in sight. There is no way we are all collectively taking a year-long vacation, and our psyche’s are just realizing, now it is back to our regular, difficult jobs.

So, what is YOUR Covid Recovery Status on the grid below?

from: Responder Stress Continuum, via CU Anschutz Psychiatry presentation

We are starting to use this Stress Continuum Model to assess ourselves, and each other. More than ever, we need to take care of ourselves, and each other.

CMIO’s take? I hope all of you DO find a way to ‘take a break’. Although it is not a celebration, we SHOULD recognize that we stood on the front lines of an astounding moment in history. I am proud to have stood with all of you.

Navigating Open Notes and the Information Blocking Rule: an AMA innovation panel discussion

AMA Physician Innovation Network Avatar
from the AMA-Assn.org website

https://innovationmatch.ama-assn.org/groups/ama-physician-innovation-network-public-area/discussions/navigating-open-notes-and-the-information-blocking-rule

There are a whole bunch of Open Notes experts (and also me!) on a panel this week (ends tomorrow!) discussing Open Notes experience in regards to the Information Blocking federal rule. Come join us! Ask challenging questions! See what others have done! Lots of discussion on the pros and cons, the pitfalls and the successes.

“The unattainable best is the enemy of all the available betters” @Bill Burnett

You have more than one life in you. Lets ideate THREE 5-year visions. Do this exercise to generate creative possibilities. — Bill Burnett

In my clinical practice this week, I met a patient with whom I discussed this idea: he was a senior administrator in an academic institution, highly accomplished, well respected, and yet quite miserable at work and at home, feeling trapped.

It made me think back to Design Thinking principles, and creative approaches to hard problems.

Having been to the Design Thinking for Social Systems short course at Stanford, I’ve been working to apply this thinking at work and at home. I posted last year on my enthusiasm for design thinking as a process and approach to creativity and innovation. I came across Bill Burnett’s online video which prompted me to dive back into the material again.

A couple of books to recommend.

Designing your life by Bill Burnett and Dave Evans. More about applying design thinking principles to your life.

Bill also gives an overview in his great Stanford TEDx talk.

Creative Confidence by David and Tom Kelly. A history and principles of design thinking by some of the originators

Designing for Growth by Jeanne Liedtka and Tim Ogilvie. A practical book for application of design thinking. See also the Field Guide.

It made me think of myself, my work, my home, and how “designing your life” might be an exercise we could all apply with immense benefit. Join me?

CMIO’s take: What are you waiting for?

Predictive Analytics or Predictive Shrub?

What can informatics learn from a plant?

https://www.wired.com/story/the-humble-shrub-thats-predicting-a-terrible-fire-season/

The chamise plant in California is a harbinger of a high risk fire season this summer. Fascinating analysis of ecology-based prediction.

CMIO’s take: What can informatics learn from a plant? Sometimes simple methods can be effective.

Fight Disinformation. Journalists, Scientists Unite!

From wired.com

https://www.wired.com/story/opinion-disinformation-researchers-must-work-with-journalists/

I find it does not serve the needs of the community or the world to be merely a scientist. One must also be a communicator. In this age of disinformation, we are drowning in the social media morass. The voice of science, of reasoned, thoughtful scientifically based research is too quiet. Our Filter Bubbles allow us to read online articles that only confirm our biases instead of finding objective, reports that speak to actual evidence. This article is a clear explanation of why journalists and scientists should work hand in hand to raise our voices and be heard.

“Please do your best today”. Not a dry eye in the house.

We need to focus on bringing humanism back into healthcare, to combat the temptation of the e-patient (EHR computer chart and electronic or telehealth communication) numbing us to the suffering of real patients out there. This is a terrific read.

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