In the world of ideas, well-written posts speak loudly. I have struggled to put coherent words together, and to post regularly enough to establish a voice. Those of you who have read and commented and “liked”, thank you. Both of you.
However, I have a sister. Michelle (@M_Lin) is an academic Emergency Department physician at UCSF-SF General Hospital, and runs an award-winning, million-follower medical website, called ALiEM (www.aliem.com). At least one colleague has quipped: “Michelle is your SISTER!? Wow, she must be the smart one in your family.”
So be it. Kudos to the smart one. Her most recent article celebrates the brand new partnership between ALiEM, representing the new digital frontier of healthcare, with a well-established brand in medical literature, the Western Journal of Emergency Medicine. Congratulations, sis!
I’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.”
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.
Well, I’m not sure what to think. I read this because of my book club, where we read Juan Thompson’s book “Stories I tell Myself”. He’s Hunter’s son, and writes well in his own right (and, works in Healthcare IT in Denver!). Moreover, this was an opportunity for me to read some literature of the Gonzo generation that I never got around to. Juan mentioned the lyricism of Hunter’s description of being on motorcycle barreling down Pacific Coast Highway at midnight. This prompted me to pull Hell’s Angels off my wife’s bookshelf, and then I was hooked.
Diving into the book, Hunter takes you inside the California Hell’s Angels, the (intentionally) bad press, why they smell bad, how “looking for a fight” gave them a raison d’etre, and perplexingly, how news coverage elevated them to a national phenomenon, when otherwise, they might have faded away. Its a love song about the dispossessed, beautifully reported and written.
It’s far from my personal experience, and an opportunity to walk a mile in shoes I would never otherwise wear.
CMIO’s take? There are leadership lessons everywhere you look: from brilliant police captains who narrowly avoid pitched battles using mundane traffic cones and enforced curfews, to Hell’s Angels chapter leaders using nimble telephone trees to assemble a flash-mob, before there was such a thing as a flash-mob.
I’m grateful to work with lots of smart people. One of them is Zuzanna Czernik, who is first author on a paper recently published in JAMA. She notes the current despair about how Electronic Health Records (EHRs) take us away from the bedside of the patient. Her surprising investigation reveals that research studies, over the past 60 years, consistently state “residents spend surprisingly little time at the bedside.” I enjoyed co-authoring paper, and helping to find a light at the end of this tunnel.
Hello world! Inspired by others (Tosha Kowalski, John Halamka, my famous sister Michelle Lin), I’m taking my first stab at a public blog with musings about Electronic Health Records, Patient Portals, information transparency, life as a CMIO, organizational change, psychology of individuals and organizations, communications strategies, science fiction, little black books, saving the planet, and anything else I find cool or interesting. Navel-gazing in short. I promise to keep it short. Hope you drop in from time to time. CT Lin MD