The KHIT Blog: #HIMSS16 Final Day

Friday, March 4, 2016

#HIMSS16 Final Day

First, I cannot believe I sat there last night at my sister-in-law's place and watched that entire junior high locker room towel-snapping competition. This is what happens to me when there's too much wine. This also happens: "Your Daily Donald™"

Just saw this over at STATnews:

Republican health care experts dismiss ‘buffoon’ Trump’s ideas
By DAVID NATHER @DavidNather

WASHINGTON — The rise of Donald Trump has been disappointing for establishment Republicans — and downright excruciating for conservatives involved in health care policy.

Even after the release of his health care plan Wednesday, Trump strikes many of them as barely familiar with the most basic conservative health care ideas in their life’s work. In interviews, some of the most influential Republican experts on the issue told STAT they’re dismayed by what they consider the GOP front-runner’s lack of understanding of health care, his inconsistent statements about what he really believes, and his embrace of populist ideas for lowering drug prices that are straight out of the Democratic playbook.

It’s not in most policy experts’ nature to lash out or lob colorful insults at a presidential candidate, the way politicians and operatives do. But thanks to Trump, these are not ordinary times...

We didn't hear anything of substance regarding federal health policy at last night's GOP political C.diff mutual insult-fest. All we got between pre-adolescent barbs was lame repetitive stuff like Ted Cruz's reflexive "I will repeal every word of ObamaCare on Day One."

Right. Harvard-trained lawyer no less. Must have been out sick the day they went over Article I.

See also "The Debate That Made America Dumber." And, HuffPo has this:

Now Mitt is on The Donald's case, too. My quick Photoshop fun with The Father of ObamnyCare last go-round.

Is this a great country, or what?

I'm basically hanging around today to see Peyton's closing Keynote (I'm a UTK grad, as is my daughter). Gonna rifle through my notes from the past few days and post more thoughts. Most of my attention went to UX/UCD topics and "interoperability" (and a bit of "analytics"). The HIMSS status update on the ICD-10 conversion was pretty interesting too. They referred to it as "largely a Y2K event." While coding productivity is down somewhat (to be expected, at least transiently), claims denials have not been all that noticeable. Onward to ICD-11...

After the closing Keynote, given that my wife is over in Japan and Okinawa for work for 10 days, I'm gonna drive down the 15 to L.A. and stay in a B&B two blocks from the Hollywood apartment where my late elder daughter (and I) lived during her illness, spend some time ambling around for feelings that may dissipate my writer's block in finishing the details of the last six month's of Sissy's life -- all part of the book I'm working on.

ERRATUM

My running joke with Health 2.0's Matthew Holt:

Kudos to HIMSS. At the Health 2.0 Conferences we get the neurotically healthy skim milk, soy milk, or rice milk. Ugh.
___

PEYTON CLOSING KEYNOTE

I'd wondered whether turnout might be relatively light. Wrong. It filled up.

Close to showtime, I got collared, first by a volunteer staffer, then by a HIMSS exec. "No photography allowed, sorry."

I pushed back with the HIMSS fellow, wondering whether I might cross a line and get tossed, HIMSS16 press pass notwithstanding. "Dude, that ship has sailed. There are 3,000 people in this room with smartphones. They'll all be taking pictures. And, I've been covering these for four years now without any problem." Showed him my HIMSS media badge. "Sorry. No photography."

Whatever. I started packing my camera bag, and thought about blowing it off and leaving the pending Keynote to get a head start on my trip to Hollywood. I'd heard down in the press room that ESPN and other press were trying to crash the party (on speculation that Peyton might announce his NFL retirement), hence the reflexive viligance, I guess.

He came back shortly. "I apologize. I got clarification. Just no video."

"Thanks, I appreciate it. I'm not shooting video." We exchanged cards.

He's the HIMSS national COO.

Some pics...

Michael Zaroukian, MD, incoming HIMSS Chair

Dana Alexander, RN, outgoing HIMSS Chair

'eh?

"Football is a game. Revolutionizing healthcare is a mighty endeavor. I can’t even come close to doing what you do."

He gave a great speech, self-deprecating, funny, polished, sincere, and inspiring. And totally relevant to the Health IT community. Glad I stayed (though I, like a lot of attendees, left prior to his closing post-speech discussion segment.)

See MedCity's recap here.

"NO VIDEO"

Jus' sayin'...

DONE

Back in California. I know every rock and bush on the 15. Off to Hollywood for the weekend.

The Stateline Solar Park just at the foot of Mountain Pass CA is really something to behold. I loves me some solar.

Still have HIMSS16 session notes to expand on. Stay tuned.

____________

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
___

"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
___

"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
___

"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
___

"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
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"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
___

"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.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Friday, March 4, 2016

#HIMSS16 Final Day

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