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Wednesday, September 19, 2018

The "Silver Tsunami" and health care

I need to Photoshop myself onto that bench, first wave baby boomer that I am (born in Feb 1946).
Some good news: my cardiologist told me Friday that it was indeed a viable goal to get me all the way back to my delusional full-court hoops gym rat Jones. I start cardiac PT rehab on October 9th.
The 2018 Health 2.0 Annual Conference just wrapped up in Santa Clara. I find distressingly little mainstream press coverage, via searching Google News. Some stuff is just regurgitated press release copy.

Above, HIMSS CEO Hal Wolf:
Every hospital has to innovate for Silver Tsunami
The aging population is becoming more educated and driving transformational change, Wolf said at Health 2.0.

SANTA CLARA, CALIFORNIA — The worldwide challenge of treating aging populations is driving the healthcare industry toward innovation, according to HIMSS CEO Hal Wolf.

Speaking at the Health 2.0 conference here Monday, Wolf said that in the U.S., 49 percent of healthcare costs are covered by the government, yet as the ‘Silver Tsunami’ continues, that cost is expected to leap to 53 percent. But the problem isn’t just money, it is also the lack of manpower and skilled providers to take care of the aging population. Currently there is a gap of 7 million healthcare professionals, but that gap is only expected to grow, he said.

“That is why purely and simply … every healthcare system in the globe is trying to figure out how they are going to use innovation to take all of this [sic] disparate and disconnected components [and] bring it [sic] back together, so we can deliver care to rising populations, that are going to be sicker,” Wolf said. “That is what is siting behind the rising investment digital health. It is not something that is going to easily burst because the drivers that sit behind it are not the evaluations themselves as much as the socioeconomic drivers.”

Many are looking toward data as a way to solve problems in healthcare, as more and more of it becomes readily available. But data alone isn’t [sic] the solution, Wolf said.

“Data is [sic] fundamentally useless until you turn it into information,” Wolf said. “Until you take the data that is [sic] ones and zeros and categorize it, and put it [sic] into digestible chunks, we do not have the ability to use it [sic] the way we want to. If you think about your own apps or apps you’ve worked with, it is about taking that [sic] data and turning it into information … that information when you do comparative analysis turns itself into knowledge. This is where knowledge management is so important because it creates standards and targets and goals. There is inside knowledge and outside knowledge. Then finally when we apply little bits of data targeted against clinical utilities or capabilities or services that [sic] is what we deliver to the healthcare system.”

Healthcare is often behind on innovation. Wolf said the system is playing catchup to other industries in someways. For example, he said that his dog had a registry at its vet before his son had one at his doctor's. That doesn’t mean healthcare should catch up to old technology — rather, should be looking towards new better innovation like a segmented personalized registry. For example, a patient being treated for breast cancer shouldn’t get a breast screening reminder.

But it isn’t just the healthcare systems that are looking to change. Wolf also stressed that patients are becoming more engaged and informed about their health…
Tangentially related prior post: "Are we 'overcharged' for health care? Will it get even worse?"

Hmmm... "Innovation?"

A fine, relatively quick read. Short easily digested chapters with "accelerator" queries following each one. e.g.,

“The world makes way for the man who knows where he’s going.” - Ralph Waldo Emerson

I’ve repeatedly seen it—successful people have a future orientation. They may not know exactly how they’re going to get there, but they have a crystal-clear vision of their intended destination. Underlying this vision, storming towards the uber-successful is a three-step framework involving Clarity, Focus, and Execution.

I first learned the power of this trinity by accident. I worked my way through college as an emergency medical technician for a hospital-based ambulance service. I decided to major in respiratory therapy for one simple reason—I wanted to be a member of the flight team aboard Angel One at Arkansas Children’s Hospital. The day I began the professional portion of the respiratory therapy program, I waltzed into the department director at Arkansas Children’s Hospital and declared, “I just began respiratory-therapy school, and when I graduate, I’m going to come here and fly on your helicopter. So, if you’d like to hire me—know you can train me during the next few months, so I’ll be ready when I graduate.”

I didn’t get the job that day. A few months later, after observing me during a clinical rotation, that department director hired me. The day after I graduated, I was a member of the Angel One Flight Team. I spent the next several years living my dream. Fate had another surprise in store for me: another member of that team was my future wife, Lori.

Successful people have clarity on where they are going. They develop a relentless focus on that destination, and they understand how to impeccably execute that plan. Those three keys can make the difference between where you are and where you want to be. Make it happen!

  • What does your ideal future look like in three, five, and/or ten years? Spend the time necessary to develop crystal clarity on that desired future.
  • On what things must you intently focus to fulfill that vision or to arrive at that desired destination?
  • What things must you achieve or accomplish in the next twelve months to take you as far as possible toward that vision or destination?
  • What key actions must you take daily or weekly in order to achieve or accomplish those twelve-month milestones?
Standridge, Dr. Jeff D.. The Innovator's Field Guide: Accelerators for Entrepreneurs, Innovators and Change Agents (Kindle Locations 224-247). Fitting Words. Kindle Edition.
And so forth for 52 topical chapters.

This preface setup is noteworthy:
Innovation in any setting can be daunting. Being an entrepreneur is gut-wrenching, and filling the role of change agent takes a level of energy that most do not feel they possess. When you have the responsibility of being a change agent in your business, organization, or community, the burden of leadership weighs heavily on your shoulders…
…Innovation in any setting can be daunting. Being an entrepreneur is gut-wrenching, and filling the role of change agent takes a level of energy that most do not feel they possess. When you have the responsibility of being a change agent in your business, organization, or community, the burden of leadership weighs heavily on your shoulders… [ibid, Kindle Locations 184-186].
"The burden of leadership." Yeah. More, from the IHI Forum.

Relatedly, I'll reprise something from a December 2017 post of mine.

Below, I finished this book. Very good.

Dug it. Although, for a book claiming to have "launched the Lean Startup revolution," there is precisely nothing in it going explicitly to Lean methodology practices. Putting the "customer discovery / customer development" processes ahead of the "product development process," yeah, I get all that (and, charitably, it's foundational to a Lean philosophy, in many ways a direct descendant of Deming). But, no discussion of key topics such as "PDSA," "Value Stream," "Gemba," "Kaizen," "the 5 S's,", "A3," "Fishbone Diagram," etc.

I kept getting a recurrent feeling: "yeah, this is largely good old MBA (albeit PDSA-iterative) SWOT analysis stuff."

One thing I find consistently missing from these "innovation / startup" tomes are any substantive methodological discussions regarding old-fashioned scut-work "cost center" organizational functions -- i.e., in Lean "value stream" lingo, the "no-value-add-but-necessary" processes. Standridge at least tangentially makes mention of it in passing:
Entrepreneurs innovate while simultaneously being change agents. If wearing those hats isn’t stressful enough, payrolls and payables have to be met. Entrepreneurs must make certain their customers are served, their employees are paid, and their bills are current, while also ensuring life needs are met. No matter what blows up at work, the kids still must be housed, shuttled to school, fed, clothed, and put to bed… [ibid, Kindle Locations 198-201].
I'd just like to see more detailed and actionable "cost center process management" advice in the current startup literature. Tossing out broad allusions to "Lean," "Agile," "Innovation," (even "Effectuation") etc leaves me still a bit wanting.

I've reflected before on my own distant, haphazard tenure as a startup partner back in Tennessee:

Back in the 80's, while working at the International Technology Corporation environmental radiation lab in Oak Ridge, I was a Principal in an "exam cram" A/V business with a professor at UTK who taught private exam prep courses (e.g., SAT, ACT, GRE, LSAT) on the side. We started a company and then produced and marketed a series of 2-hour VHS videos and their accompanying print booklets in my South Knoxville hole-in-the-wall studio.

We bought "targeted" mailing lists (i.e., school guidance departments, libraries, and families with kids in school at the right grade levels) and sent out mass mailing brochures. The rule of thumb in Direct Mail back then was that a 1% return/sale rate was sufficient to be profitable were your costs fully baked in and your retail pricing still competitive.

I was the Managing Partner (Corporate VP/Sec'y-Treasurer/Registered Agent, actually). Producer, Director, Editor, Copywriter, Layout Artist, and Data Entry and UPS Shipping Clerk.

There's gotta be a DSM-V code for that...
Seat-of-the-pants multiple-hats improv management, those days.

Had I not had to miss the 2018 Health 2.0 Conference, I'd certainly been asking these types of questions of the startup atttendees.


A shot from a Twitter post (hashtag #health2con). Probably from a smartphone. There's ever-less point for my schlepping around 20 lbs of DSLR cameras and lenses, given improvements in smartphone optics.

"EMR Evolution: How the Big Players are Changing the Game"

Really would have liked to have seen that one. As noted by MobiHealthNews back in August:
Though doctors likely don’t consider their EHR a cutting-edge technology, the EHR space is actually a front line for change and innovation in healthcare. And that change is happening on a number of different axes: interoperability and open standards, personal health records, and the move into public cloud infrastructure are some of the biggest change narratives.

Microsoft, which provides technology to power many of the major EHR vendors, has a dog in each of those fights, and Microsoft Chief Medical Officer Simon Kos will be one of a handful of presenters on a Health 2.0 panel called “EMR Evolution: How the Big Players are Changing the Game,” along with representatives from Google Cloud, Cerner, and Allscripts…


Ran across this, mentioned over at Wired. The book is to be released on the 25th.

From the Amazon blurb:
Dr. Kai-Fu Lee—one of the world’s most respected experts on AI and China—reveals that China has suddenly caught up to the US at an astonishingly rapid and unexpected pace.  

In AI Superpowers, Kai-fu Lee argues powerfully that because of these unprecedented developments in AI, dramatic changes will be happening much sooner than many of us expected. Indeed, as the US-Sino AI competition begins to heat up, Lee urges the US and China to both accept and to embrace the great responsibilities that come with significant technological power. Most experts already say that AI will have a devastating impact on blue-collar jobs. But Lee predicts that Chinese and American AI will have a strong impact on white-collar jobs as well. Is universal basic income the solution? In Lee’s opinion, probably not.  But he provides  a clear description of which jobs will be affected and how soon, which jobs can be enhanced with AI, and most importantly, how we can provide solutions to some of the most profound changes in human history that are coming soon.
'Eh? See Sinovation Ventures.

Cool logo.


Screen cap from my iPhone:


More to come...

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