The KHIT Blog: The Blog turns 4

Saturday, May 10, 2014

The Blog turns 4

With the REC initiative winding down -- heading quietly off the national health IT stage in "no-cost extension" mode, and given that I have retired from the program, it is time to finally execute a name change. I will continue to use the old URL while I lock down the explicit URL custom domain, but the re-direction URL "Blog.KHIT.org" will get you here. I've been mirroring these posts at KHITblog.blogspot.com, but that seems like a duplicative waste of effort and bandwidth, so I may soon quit doing that. Too much hassle to migrate everything in my right-hand Links column.

I originally registered both "RegionalExtensionCenter.blogspot.com" and "RegionalExtensionCenters.blogspot.com" (I use the free Blogger.com), with the latter simply "squatted" to prevent someone else from getting it and causing confusion with my active REC blog work. My masthead title was "The HHS Regional Extension Center Blog," but I always noted that it was not a HHS project, but was a in fact private, independent undertaking. This is what the marketing peeps call "positioning." Today, the simple phrase "REC blog" entered into a Google search (even absent the quotes) returns this blog as the first search result. Didn't pay a penny for that. Meta-tags, baby (among other SEO things).

I launched this effort four years ago today. My initial post was entitled Opportunity for collaboration? ASQ and the RECs. I have to admit to disappointment that I never got any traction with the collaboration. I am a senior member of ASQ and continue to believe it could bring a lot to the healthcare and health IT tables. ASQ Healthcare Division Chair Dr. Joe Fortuna agreed, and invited me into the Division Leadership Council, and we made repeated proposals for pro bono collaboration with ONC.

ONC, though, exuded a "not-invented-here,-not-interested-here" indifference, and the various relevant ASQ Divisions seemed equally uninterested. In fact, the only feedback I got early on after pitching the idea around the Society was a that of being admonished by some dope in the Software Quality Division for "using the ASQ logo without permission" on my blog.

Seriously, bro'? That the best you can do?

We see how far that got him.

I attended seven major healthcare and Health IT conferences and events in 2013 for the blog (HIMSS13, Health 2.0 Refactored, California State HIT Day, Lean Healthcare Summit, Health 2.0 2013 Annual, NYeC 2013, and the IHI 25th Forum). I was apparently the only ASQ member at any of them. Sigh...

The other weird thing that went down at the launch of this blog was the upshot of my mistake in having had the impolitic temerity of directly contacting my CEO, Marc Bennett with the good news of Dr. Fortuna's interest in helping the REC initiative. I got immediately and publicly upbraided within HealthInsight by our then-REC Executive Director for "exceeding your scope." The soap opera Uproar was pretty lame.

I thought I was gonna get fired after only two months into the job. It was stressful. It sucked. I was blindsided. My relationship with Marc went back to the early '90's, when the Utah Peer Review and Nevada Peer Review were merged to form the bi-state HealthInsight. Marc was on the Communications team and I was an analyst. Way antedated the tenure of this particular ED. I was unaware that I was now not to directly approach His Most Serene High CEO-ness.

Cooler heads prevailed, though, and she never brought it up again. The Big Emergency Inquisition Meeting never happened. 314 posts later I am still blogging, still supporting the now-mostly moribund REC program, and still trying to add content and perspectives of value to the healthcare and Health It spaces. My interests, as regular readers of this blog know full well, go way beyond just IT to process improvement and rational healthcare and Health IT policy.

I don't get paid for any of this. I do it because it's important. I'm "retired" now, and have been joyfully catching up with life with my awesome wife after five years of difficult work separation (and dealing with some of the inevitable chronic health issues that come with my age). I'm behind on some of my prospective KHIT work, but I will catch up. I have two books to finish writing, and more reading to do than I can possible ever keep up with. Some KHIT stuff remains under wraps 'til I get them done.

Spending some quality time with my guitars, too. And, last night I exercised my live performance photographer chops by attending a benefit performance in Mill Valley at the Throckmorton Theater for the "3 Still Standing" documentary project. I'll be dumping, triaging, and posting my shots from last night to my Facebook page and another of my blogs as soon as I finish here.

Lots of important stuff to continue to write about. And, if you would like to write for/cross-post with the KHIT blog, just let me know. My traffic numbers are pretty decent; you'll get good exposure.

Thank you for your continued interest.

- BobbyG

UPDATE:

Some of my shots from last night, uploaded to my Facebook site.

___

More to come...

2 comments:

John Lynn - EMR and HIPAAMay 12, 2014 at 6:26 PM
Happy 4th Birthday! Quite a labor of love and much appreciated by me and many others.
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BobbyGMay 12, 2014 at 6:31 PM
Thanks, John. High praise coming from you!
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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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Saturday, May 10, 2014

The Blog turns 4

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