CHIME’s CMIO Leadership Academy in Ojai. Listen and learn.

http://chimecentral.org/mediaposts/cmio-leadership-academy-2019-images

Thanks to George Reynolds and those organizing CHIME’s recent Leadership Academy for existing and upcoming CMIO’s. I enjoyed teaching this year with other co-faculty like Brian Patty, Natalie Pageler, Cindy Kuelbs, George, Howard Landa, Keith Fraidenburg and David Butler.

The topics we covered in our Academy over 2 days included such CMIO best hits such as:

  • The Role of HIT in Today’s Provider Environment
  • Setting Vision and Strategy
  • Making Change Happen
  • Creating Buy-In
  • Demonstrating Business Value
  • Budgets and Business Plans
  • Creating Effective Teams
  • Instilling Customer Service as a Value
  • Organizational Culture
  • Building Networks and Community
  • Achieving Life/Work Balance

Thanks to my awesome and inspiring faculty colleagues; I learned a ton as a N00bie faculty member, and got lots of new books to read, for example Brian Patty’s “What Customers Crave.”

CMIO’s take: See one, do one, teach one is the norm during internship and residency training. Sometimes Teach One ends up being the best learning of all. And, join us next year at CMIO Leadership Academy.

New PIGlet? Or, interested in medical informatics? How to start…

Piglet: ie a New PIG (physician informatics group member)

Are you a PIGlet? Someone interested in the field of medical informatics? One of our newest informaticists coined the term PIGlet (Physician Informatics Group member). Cute. Increasingly I’m meeting with medical students, medical residents and now physicians as well as allied health persons (nurses, physical therapists) interested in the field, and unsure how to get started. Well…

Fallacy: informatics is about designing computer screens and talking with vendors about features and screen design.

Fallacy: informatics is about going into a dark room, creating a fantastic tool and launching it into the public and collecting all the acclaim from co-workers who instantly understand why you are requiring more clicks and typing to complete your amazing new software package.

Fallacy: informatics is about being smarter than everyone else and just KNOWING that your solution you cooked up in your head is going to work for everyone IF ONLY THEY DID THINGS THE RIGHT WAY, like you.

Instead: informatics is about creating a vision of what healthcare COULD BE, empowered with knowledge. This is a team sport. It is about collaboration: collecting everyone’s best ideas, developing consensus, trying a bunch of things in small batches, seeing what works, and then making a big bet, measuring outcomes, and diving back in for the next cycle of improvement. Done well, Informatics is Design Thinking and Teamwork, and the “information technology” is just how it is implemented. This is completely the opposite of what many think informatics is.

They’re … wrong.

Here are some ideas for getting started. A fair number of these are associated with a TED talk or other online video summaries.

  1. Read about informatics (but ONLY after reading about leadership and organizational change)
    1. Lorenzi, Riley, Managing Technological Change
    2. Journal of the American Medical Informatics Association
    3. The Design of Everyday Things (Norman), others
    4. Nudge (Thaler)
    5. The Glass Cage (Carr)
  2. Books to read (leadership, culture change, a book club if you’re lucky)
    1. Leading Change (Kotter)
    2. Good to Great (Collins), and others
    3. Death by Meeting (Lencioni)
    4. Delivering Happiness (Hsieh)
    5. Tribal Leadership (Logan)
  3. Books on self improvement
    1. Getting Things Done (Allen)
    2. Deep Work (Newport)
    3. The ONE Thing (Keller)
    4. Atomic Habits (Clear)
    5. The Practicing Mind (Sterner)

There are blogs:

Above all, be curious, be useful, pace yourself, take care of yourself so that when opportunities arise, you can occasionally sprint into action. Create learning habits to stay abreast of changes that affect your clinical practice and that of your colleagues. Read broadly about other industries unrelated to your own, and how problems are solved elsewhere.

CMIO’s take? Informatics has become a crucial part of medical training. The most commonly used (and often hated) tool for physicians today is the EHR; more common than the Yankauer, the retractor, the scalpel, the stethoscope, even. Why not develop exceptional skills with this tool? Until it matures into a self-aware entity (! a later post), it is on US to shape it into a useful tool.

Getting to Yes (Book review)

OK, nobody has time to read an actual book, so here is William Ury speaking at Creative Mornings about his book. Do you have 30 minutes to be a better person? Ever seen the arm-wrestle exercise? Watch the video.

I’ve read his book several times now. At least put it on your bookshelf. My take-aways for me and my colleagues and my work. We discussed this in our Large PIG book club recently.

  • Separate people from the problem. Personality is NOT at issue. Avoid blame on either side
  • Focus on interests, not positions. Be curious. See (and demonstrate your understanding of) the other party’s position clearly
  • Learn to manage emotions. Allow expression of strong emotions. Else, may block clear thinking
  • Express appreciation. Reflective listening (data, ideas, feelings, values). Seek others’ perspective.
  • Put a positive spin on your message. Avoid blame.
  • Escape the cycle of action and reaction. Instead, explore interests, invent options for mutual gain, leverage differences, brainstorm jointly as “wizards” (lower level persons who are permitted to work on ideas without leadership pressure)
  • Prepare your BATNA (Best Alternative To Negotiated Agreement) What will you do if you don’t agree?
  • Seek a third party who is trusted by both sides
  • Be SOFT on the people (care about the person), HARD on the problem (principled thinking)

I’ve read authors with similar points:
-Steven Covey: Listen first to understand, THEN speak to be understood
-Crucial Conversations: Make it safe to converse, Control your own stories, Contribute to shared pool of meaning, Ask other’s interpretations, Be tentative in your theories, Seek win-win opportunities.

CMIO’s take? This is a foundational book for Informatics and leadership in general. Find time to learn these lessons. Find the win-win.

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.

Denver Regional Clinical Informatics Summit (and ukulele) – second annual, hosted at UCHealth

Okay, so you’re probably here for the Informatics knowledge, but too bad, we’ll lead with ukulele. Thanks to Dave Beuther for writing us a world-premiere song parody of Grace Vanderwaal’s “I don’t know my name” ultimately winning America’s Got Talent a couple years ago (meaning Grace, not Dave).

I’m really grateful to our Denver Region sister-health-systems. We have quite a few health systems in our region with Clinical Informatics expertise, and we spent the better part of a day getting to know each other, conduct round tables, and discuss our common challenges in designing next-generation, innovative Electronic Health Records to improve the care of patients in Colorado. Thanks to attendees and leaders from: Boulder Community, Steamboat (Yampa Valley), Centura Health, Children’s Hospital Colorado, Denver Health, Kaiser, National Jewish Health, SCL Health, UCHealth and the Denver VA Medical Center.

Amy Hassell explains how components of the Virtual Health Center work to Summit attendees from across Metro Denver

We had about 30 attendees from various health systems touring our Virtual Health Center (VHC), seeing our capabilities for Virtual ICU, Virtual Remote Monitoring, Virtual Urgent Care, Safety View, Telemetry and more.

About 50 attendees participated in our afternoon Clinical Informatics Seminars, a series of Round Table discussions ranging across such topics as Clinical Documentation, Order Sets, EHR burden and optimization, Physician Builders, Virtual Health, Innovation, Clinical Decision Support, Analytics and Data Science. Whew!

What’s a good conference without a Selfie?!

We wrapped up the day with an evening CHIMSS (Colorado chapter Health Information Systems Society) event with a keynote by Dr. Rich Zane on Innovation in Healthcare.

This was followed by a panel discussion on innovation with Brandi Koepp, Pharmacy Coordinator, UCHealth, Paul Schadler, SCL Health, David Beuther, National Jewish Health.

Here are the reviews of the event! https://www.surveymonkey.com/stories/SM-P7KFLZDL/

The evening CHIMSS event in the Bruce Schroeffel Conference Center main auditorium @UCHealth

CMIO’s take? Although we could probably benefit from more frequent information sharing and collaboration, for my taste (as coordinator), once a year is pretty good! It is cool what our sister health systems are doing to improve the care of patients; we are better together!

Video: Dr. Sieja discusses EHR Optimization Sprints

Congratulations to Dr. Sieja and team for publication of UCHealths’ experience regarding EHR Optimization Sprints. You can do it too! Read about our published experience at Mayo Clinic Proceedings.

https://www.mayoclinicproceedings.org/article/S0025-6196(18)30788-2/fulltext#appsec1

There are several online supplements: additional specifics about how we conducted the program (30-60-90 day planning meetings, agendas for the 2 weeks of activity, etc), and the actual pre and post-intervention surveys.

Optimization Sprints: Improving Clinician Satisfaction and Teamwork by Rapidly Reducing Electronic Health Record Burden (published in Mayo Clinic Proceedings Feb 2019)

Sprint team action shot!

Congratulations to Amber Sieja, Katie Markley, Jon Pell, Christine Gonzalez, Brian Redig, Patrick Kneeland, co-authors on our published article in Mayo Clinic Proceedings this week. I’ve spoken of some of the details on this blog, so I’ll let the paper speak for itself. Nice to be recognized! Coming soon: a video by Dr. Sieja explaining some of the highlights of the paper.

https://ac.els-cdn.com/S0025619618307882/1-s2.0-S0025619618307882-main.pdf?_tid=c94d2fe7-8f2b-4e66-9852-277fb952f3eb&acdnat=1551313804_a8d687bb190fdb632cd1ed9f45c8ef41

CMIO’s take? When team members do great work, we all get better.