The KHIT Blog: Health 2.0 2014 Day Two

Wednesday, September 24, 2014

Health 2.0 2014 Day Two

I have to say, the lighting is good (except in a few of the smaller ballrooms). As it is at the HIMSS conferences. Some of the others I've attended, not so much. Having done a lot of live performance photography in Vegas during my many years living there (see these as well), I'm a bit spoiled to pro lighting (although, candidly, I was frequently whining to the FOH cats (Front of House) for more white spots, more evenly distributed (overdeployment of red and amber gels in particular are the bane of live performance ambient light photography).

My summary take on Health 2.0 2014 thus far is one of awe and respect for the mountain of fine apps programming I've seen on display, and a feeling of being humbled in the presence of so many incredibly smart and dedicated people. I have to wonder, though, about how many of the apps and systems I've seen this time around will still be up and running three years from now, notwithstanding the best efforts of these incredible people. I guess that's how progress has to work.

LOL. Brain Bleach Alert. You just can't unsee that. Jonathan Bush and my pal Fred Trotter. Lordy. I tweeted that Jonathan Bush is "the Robin Williams of Health IT."

I'm behind on blogging this event, given that I really have not been feeling well all week. I'll catch up.

A high point of the day for me by far was the "Unmentionables" panel.

Particularly moving was Vic Strecher's presentation recounting his path since the death of his 19 yr old daughter. We talked afterward. He gave me a copy of his new book.

When Vic Strecher lost his daughter, Julia, to a rare heart disease, his world ended. Only it didn't. Vic's wife, Jeri, and older daughter, Rachael, were still very much alive, as were his two demanding careers. What did end was his worldview: one based on long-held assumptions and beliefs about life, death, disease, health, risk, and ultimate purpose-subjects on which he had been writing and speaking for years-but the validity of which he now questioned.

Vic's experience of being "broken open" (to take bestselling author Elizabeth Lesser's phrase) set him on a life transforming journey through ancient and modern philosophy, literature, psychology, neuroscience, and Egyptology. Along the way, Vic was introduced to an unlikely role model: a six-legged superhero whose unique relationship with a ball of excrement forever altered Vic's outlook. A self-help guide, college lecture, confessional, and time-travel adventure all rolled into one, On Purpose uses a beautiful, fantasy-fueled, graphic novel format to tell a story of self-discovery and personal growth you'll never forget.

From the Foreword: "Writing this book has given Vic Strecher a powerful sense of meaning. Reading it may do the same for you. It did for me. The light drives out the darkness and we can experience our world anew, filled with pleasure, joy, and meaning." - Dean Ornish, M.D.

See also DungBeetle.org. As a still-vestigially-grieving parent, I could totally relate. And, I can see that I still have much to learn.
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More to come shortly. Gotta get moving and get over the the Convention Center.

UPDATE

Random shots from Day Two, starting with Vic's wellness app.

The fabulous "Unmentionables" panel: Alexandra Drane and Susannah Fox

Serious Underachiever Dr. Mike Painter of RWJF /s

Jonathan Bush demonstrates the Non-Latte Salute.

Esther Perel, author of "Mating in Captivity"

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More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
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"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
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"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
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"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
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"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
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"'Solutions' exist only in mathematics."

- Karen Martin
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"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
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"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

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Wednesday, September 24, 2014

Health 2.0 2014 Day Two

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