The KHIT Blog: #HIMSS16 Day 2

Wednesday, March 2, 2016

#HIMSS16 Day 2

No HIMSS wifi, all day. The place was smartphone hot spot hell.

Every time I clicked "Select another network" the list got longer.

We're the Technology People.

Posting this from my sister-in-law's house prior to heading out to the conference. Hope it's fixed today.

Off-topic erratum: This is what I did Monday night. Wearing my other hat.

ON "BIG DATA," FROM THE ATLANTIC

IF OUR BODIES COULD TALK
The Big-Data Quest to Treat Every Disease
Mar 02, 2016
Video by The Atlantic

When Sonia Vallabh and Eric Minikel discovered that Sonia had inherited the gene for a fatal neurodegenerative disease, they quit their jobs to dedicate themselves to finding a treatment. President Obama believes that the American people may be able to help. It cost $400 million to sequence a person’s genome in 2003. Now, the cost has plummeted to around $1,000. These maps of all of the genes in our bodies are now easily and quickly attainable, along with enormous amounts of other medical data. The singular question of modern medicine is what to do with this data, and how to use it effectively, efficiently, democratically, and responsibly to improve human health...

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MY NEXT READ

Saw a post about this book yesterday on SBM.

From the publisher:

How does life work? How does nature produce the right numbers of zebras and lions on the African savanna, or fish in the ocean? How do our bodies produce the right numbers of cells in our organs and bloodstream? In The Serengeti Rules, award-winning biologist and author Sean Carroll tells the stories of the pioneering scientists who sought the answers to such simple yet profoundly important questions, and shows how their discoveries matter for our health and the health of the planet we depend upon.

One of the most important revelations about the natural world is that everything is regulated—there are rules that regulate the amount of every molecule in our bodies and rules that govern the numbers of every animal and plant in the wild. And the most surprising revelation about the rules that regulate life at such different scales is that they are remarkably similar—there is a common underlying logic of life. Carroll recounts how our deep knowledge of the rules and logic of the human body has spurred the advent of revolutionary life-saving medicines, and makes the compelling case that it is now time to use the Serengeti Rules to heal our ailing planet...

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JUST IN, VIA FACEBOOK

My comment:

Now that HHS is finally talking about "data standardization," use ONC's authority to require that all EHR vendors hand in their data dictionaries for data cross-mapping study -- like they SHOULD have done at the outset. [Link]

EHR SCIENCE UPDATE

Dr. Carter has a new post up two days in a row.

This Week on Clinical Workflow Center
by JEROME CARTER on MARCH 2, 2016

Moving from clinical workflow analysis and flowcharts to applications that use workflow technology to support clinical work is a big step. Clinical process management (CPM), an approach to clinical processes that borrows from and builds on tools and methods from the field of business process management, is the subject of the most recent articles. Enjoy!

See also his related ClinicalSwift.com. If I was going to return to coding (I last wrote an "app" in 1991 in a lab in Oak Ridge, lol), I'd probably use Apple's Swift language, among other tools.

I continue to find Dr. Carter's work extremely important. Wish he was here at HIMSS16.

HEALTHCARE MOONSHOT - THE END OF CANCER

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SOME RANDOM PICS

It's like NASCAR. HIMSS has sold ad space everywhere, even on escalators.

EPIC sculpture.

I am now in the maw of EPIC as a patient in the Muir system. Below, more exhibition hall ramble.

Yes, HL7, our current darling with FHIR and the Argonaut initiative. See here and here.

So, NaviSite invited me to a private after-hours event at RAVO. I have no idea why, but I am grateful. And, I have to sheepishly confess, I also had no idea who Jillian Michaels is.

One effusive, totally smart woman. She reminded me of my late wild-child fitness buff sportsmodel daughter Sissy.

Below, by far the best session I've attended thus far. HX360, "Data Liberation" featuring my humbling friends HHS CTO @SusannahFox and the equally crazy smart health care hacker @fredtrotter.

They tore it up. Fred demo'd some excellent interactive graphics derived from publicly released Medicare claims data.

The hope and expectation is that myriad private sector researchers will be able to effectively mine "liberated public data" in ways that HHS would never get around too.

HHS is lucky to have the smart, savvy, and humane Susannah Fox on board. If anyone can move the needle on Health IT innovation support inside HHS, it is Susannah. And, Fred! Dude is a walking diamond mine of raucous insight. I hope they video'd that session, and make it available.

Fred in 2012:

UPDATE

Susannah and Fred's session was captured on video.

CODA

Leaving the Venetian garage at dusk.

This was funny

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More to come...

No comments:

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.

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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Wednesday, March 2, 2016

#HIMSS16 Day 2

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