Upon Comparing Oneself to Others (del Giorgio)

This beautiful essay by Paul del Giorgio in the Bulletin of Limnology and Oceanography is timely and prompts a lot of self-reflection on my part. I’m talking to you: all you high-achieving physicians/APP’s who had to be top of your class year after year and never turned off that competitive streak in your career…

Original Article Here:

This prompts several questions for me:

  • Who is this thoughtful person?
  • What the heck is Limnology?
  • Is he writing this for me? (yes, he is)
  • Can Dall-E draw this for me? What would that look like?

from Bing - Dall-E generator

(from Dall-E: except this unhappy self-comparing doctor has 3 hands… and maybe extra fingers too)

CMIO’s take? This is reminiscent of my Failure Resumé. And so articulate. The entire article is a brief read, maybe 5 minutes. It was very much worth my time and maybe worth it for you. Be well, friends.

Hyperdimensional Computing Reimagines AI (wired.com)

Either I’m full of myself and over-optimistic about what I can learn, or I begin to understand dimensional computing as explained in this wired article. If so, super cool what this new way of computing holds for “explainability” of AI models in the future…

From wired.com


In college I got all the way through Calculus I and II and into differential equations and a little into matrices and vectors. I can honestly say I have used NONE of that knowledge, and it has withered completely away in the intervening decades.

THIS article got me interested. Our contemporary problems: Large Language Models, at their root artificial neural networks, compute in a way that is very power-intensive. We are seeing this already in how OpenAI and others are worrying about scaling LLM’s to more users, moving the sophistication upward from GPT 3.0 to 3.5 to 4.0 with more and more layers.

Vector or Dimensional computing holds the promise of changing the paradigm for tracking findings, storing concepts, and manipulating them more easily in, lets say, instead of a flat table of data, into 10,000 dimensional vector space.

CMIO’s take? Although this sounds like a lot of woo-woo, read the article to get the low down. Ready slowly. It took me some time to begin to get it. The reward is, maybe glimpsing a future where AI models can be made to be Explainable. Something not possible at present with LLM’s. Could be game changing.

Long term lung damage from COVID infection (NYTimes)

This is a beautiful 3-D illustration of CT scan findings of COVID infection in the lungs, and the stories of the patients who survived, and now have changed lives as a result. Sobering, and illustrates, that even though our treatments and vaccines are excellent, we still have long term consequences for some with infection. Keep paying attention: Covid is not done with us.

From the NYTimes.com



Blowing up the training classroom; also putting Roadsigns on the Highway in the EHR

Aren’t you frustrated with EHR usability? Don’t you wish you could see just-in-time guidance in the EHR? If the US Highway system can put signs on the highway, why can’t we?

From Dall-E image creation via Bing.AI browser

AMIA Panel: Signs on the roadway with Dr. CT Lin and Dr. Ryan Walsh

I enjoyed our panel discussion, encompassing two related topics:

  1. Replacing the old model of onboard classroom training for new physicians/APP’s/nurses/MA’s/staff for 8 to 24 hours, with self-paced learning modules that follow simulation training and adult learning principles
  2. Hacking the EHR to insert tips and tricks just-in-time, right where we anticipate our EHR users (physicians, APP’s etc) to get stuck with more challenging tasks. Or as we call it, Putting Signs on the Roadway.

From Dall-E via Bing.AI

CMIO’s take? We have found success with our technology innovation partners, uPerform and Amplifire. Click the link to learn!

The Fatal Uber Self Driving Car Saga is Over (NYTimes) and Automation Complacency

The classic case of the Uber self driving car, in-person monitor, and the fatal pedestrian accident, is now legally concluded. A sober reminder of ALL OUR complacencies. Or paraphrasing Shakespeare: “But, soft ye now, the fair Ophelia, nymph in thy orisons, be all my complacencies remembered.”


This made news a few years ago: a self driving Uber, under testing with a monitoring person in the driver seat, hit and killed a pedestrian (who was not as a crosswalk).

The monitoring driver plead guilty to reckless endangerment and will avoid prison time.

This reminds us of the constant and growing influence of AI and automation on our daily lives. We are all less vigilant when an assistant gets really good. Maybe 99% effective, maybe 99.9, 99.999, like with self-driving vehicles. What happens to the 0.001%?

Recently I was criticized by a medical colleague because “I wrote a prescription for a muscle relaxer, and it caused a drug interaction with the patient’s birth control medication. Epic did NOT stop me, and it should have.” The implication was, that it was Epic’s fault, and thus, those who configure Epic (CT Lin and his henchmen).

CMIO’s take? Classic automation complacency. We give the automation power over our daily lives and we stop watching carefully. Have you seen this in your work? Let me know.

Information Blocking / Sharing NEW UPDATE summer 2023

Any health systems still struggling with decisions about sharing Open Notes and Open Test Results, and how to build a win-win-win relationship between physicians/APP’s, patients and hospital leadership? Here you go, the result of years of building together at UCHealth


The general idea of information sharing between a clinic / hospital / physician/APP and their patients seems like “Mom and Apple Pie”. However, the devil is in the details. How do we approach this at UCHealth?

We do have over 2 decades of discussion on these topics, and these are now distilled for you. I’ve published earlier versions of this document (search info blocking on my blog and you’ll get them).

I was prompted by hospital leadership, as we rebuilt our “physician/APP onboarding” education plan, on how to explain Open Notes and Open Results to our newest providers. I thought of including our latest document from 2020 (wow, that is 6 internet generations ago!), but there were lots of outdated statements.

CMIO’s take? Here you go! My up-to-date version of Information Blocking / Sharing / Open Notes, Open Results introductory document for our newest colleagues at UCHealth; feel free to share amongst yourselves. If you make improvements, please let me know! We’re always looking to improve.

ChatGPT in the classroom: professors adapt (wired.com)

If you can’t beat ’em, join ’em.


from wired.com


I love this. Time for humans to adapt. How might we use this in healthcare, the idea that students / learners / ?Patients take such an assistant (currently not good enough to be the gold standard) and use it as a tool, an assistant, a learning partner INSTEAD of rebelling against the inevitable tide of the future?

Reverse Osmosis (Wired.com) we were wrong all these years?

What we got wrong before: reverse osmosis, and a new idea


I don’t know about you, but I find reading about other scientific fields refreshing and gives me a chance to think about my own field with fresh eyes. Here’s a glance at how water engineers rethought osmosis, reverse osmosis and came up with a new theory that may lead to breakthroughs for fresh water for the world.


Grok the Bones of a Good Story (a talk proposal for CHIME fall forum 2023)

Here’s a sneak peak at my newest talk. Did someone’s story defeat your data-driven brilliant proposal? Do you understand why? Like me, did you go crawl under a rock and wonder “wtf”? With luck, I’ll share this talk in November.


This is my proposal for CHIME fall forum. Storytelling for Leaders.

And recently given as a talk for UCSF’s Rehab Informatics Group.

If all the stars align, maybe I’ll see you in November?!

Your professional decline is sooner than you think (The Atlantic)

Yes, it is. Sadly, I think I’m talking about myself.

Screenshot From The Atlantic article


There is a difference, David Brooks says, between “resume virtues” and “eulogy virtues.” The challenge is recognizing when in our work lives, the second (should) become more important than the first.

A really thought provoking essay.

And, profoundly saddening.

Jump. Serve. Worship. Connect. Behave differently in the last third of your life, compared the first (primarily growing and learning) or second (working toward recognition, wealth, power).

Ray Dalio also encourages us to think about this in his book Principles (or the much more readable comic version of Principles). The arc of life is long, and many of us look at the pebbles in our path instead of the compass and the horizon.

I’ve began to value my work and home relationships more, and be less slavish to urgent, less-important emails (The ONE Thing). Turning off notifications, dipping less into social media, learning to focus, be strategic, step back and think big picture. Let others gain and grow in the spotlight.

CMIO’s take? Look at ME! I have the humility to admit that coaching and mentorship are magnificent force-multipliers and so much more gratifying than solo achievement! (see what I did there?)

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