Archive for 2010
Year in Review – Books of 2010
December 31, 2010
Following Kent Bottle’s lead in influential books in 2010, I decided to compose my own list:
- Chasing Medical Miracles The Promise and Perils of Clinical Trials. Tells it like it is – to be a participant in a clinical trial.
- Googled-The End of the World as We Know It – somewhat disappointing in that it discussed the advertising side of the business and less about the history of its technical evolution.
- DIYU: Epunks, Edupeneurs and the Coming Transformation of Higher Education. This book was recommended by a speaker at the J. Boye conference in Philadelphia. Questions the future viability of universities as they are undermined by Web 2.0 technology.
- Leading Geeks – Required reading for anyone who manages geeks, especially programmers. Helpful for anyone to understand the culture of geekdom, understanding the mindset of managing ambiguity and tearing down some stereotypes.
- The Singularity is Near by Ray Kurzweil – mind blowing futurism and undying optimism in technology even though this is from 2005 and 650 pages. The law of accelerating returns puts us on a fast track to the future. I am now following Kurweil’s Accelerating Intelligence blog.
- A Little Booklet About Health 2.0 – by Lucien Engelen. Brief but advancing health 2.0 concepts with a peak to the future from a European perspective.
- Long Tail: Why the Future of Business Is Selling Less of More – this lead to my blog post on Partnerships with Online Communities – The Long Tail, discussing some of the implications of the long tail in healthcare.
- The Collapse of Complex Societies – a venture into history and anthropology which I enjoy and blogged about: Declining Marginal Returns of Complexity
- Laugh, Sing and Eat Like a Pig by e-Patient Dave – a personal, signed gift from Dave himself when he visited Cleveland and had dinner with us.
- Connected for Health: The KP HealthConnect Story – Probably the best story of successful implementation of an EMR on a large scale basis with honest, realistic discussion of struggles and successes.
- Program or Be Programmed – Ten Commandments of the Digital Age – read appropriately as an ebook, makes some good points without being paranoid about technology’s growing role in our lives.
- The Bottom Billion: Why the Poorest Countries Are Failing and What Can be Done About It. Recommended by @Ciscoiii when visiting the World Bank in Washington, DC. Excellent analysis of failed states with recommendations at the UN level for solutions.
- Founding Faith: Providence, Politics, and the Birth of Religious Freedom – found this in Philadelphia at the Liberty Bell bookstore.
One on my shelf is Reading in the Brain: the New Science of How We Read.
More book reviews to come next year and many more will be on my Sony Reader.
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Book Review: Program or Be Programmed – Ten Commandments of the Digital Age
December 30, 2010
This quick read by Douglas Rushkoff is less ominous than the title sounds but still thought provoking. The author does not advocate becoming a programmer per se but understanding the greater control and influence over our decisions that apps have on our everyday lives. Particularly the chapter on Choice: You May Always Choose None of the Above; here he emphasizes the need to be aware of and not locked into choices made for us. Whether it is Google search results/adwords or Amazon recommendations of what others have selected, were are ever so gently guided toward choices. It reminds me of the decades old book of Alvin Toffler, Overchoice. Even then he anticipated the problem of hundreds of choices of models and colors and didn’t anticipate the ability to search millions of products online. Maybe we need tools to help us in our choices to guide us to our preferences to reduce the number of choices. But understanding enough about how this tools are programmed frees us from a type of slavery to them.
In addition, there are chapters about online identity: Do Not Be Always On, Live in Person, Be Yourself, Do Not Sell Your Friends. Increasingly, the lines between our online and offline identities are becoming blurred. Some handle this better than others, but identity confusion occurs with the most distasteful evidence in cyber-bulling and getting lost in game worlds. The advice to retain our humanity is well founded.
While the book does not address health issues on the internet and social media in depth, there are some implications for ePatients and patient-physician relationships. These need to be based in reality, not the virtual world. These identities and relationships can be extended by apps and tools but not to the exclusion of real life.
Share this:2010 Year in Review
December 24, 2010
It has been a year full of travel and accomplishments. Here is a month-by-month review:
- January – hosted Lucien Engelen and others from Radboud UMCN Hospital in the Netherlands at the Cleveland Clinic for two days on everything from the group practice model to innovation and patient experience in two days.
- February- vacation in Naples, Florida
- March – HIMSS 2010 in Atlanta presenting twice and AMIA Clinical Research Informatics Symposium presenting a poster. Also visited the Googleplex. Stopped in Salt Lake City for a day on the way home.
- April – Toronto for the - TAHSN Education Day for Healthcare Communicators – spoke on social media
- May - J. Boye Conference in Philadelphia – spoke on social media in healthcare and published my first article in iHealthbeat “Social Media in Health Care: Barriers and Future Trends”
- June – Visited Washington, DC. Vacation and some consulting
- July – Attended the Leadership Institute of the Group on Information Leadership of the American Association of Medical Colleges in La Jolla, California for a week and became a fellow.
- August – brief vacation in Salt Lake City including the Bonneville Salt Flats
- September – Named a fellow in the Healthcare Information and Management Systems Society and named in a NIH grant on Risk Calculators
- October – Presented at Toledo (Ohio) Hospital on social media and attended the CTSA Innovative Informatics for Clinical and Translational Researchers at the NIH. Did live tweeting while attending the Cleveland Clinic Innovation Summit.
- November – coauthor of an article on a disease registry in the Clinical Journal of the American Society of Nephrology and another prespectives piece in iHealthbeat on the secondary use of EMR data.
- December – Second article on the chronic kidney disease registry published. A positive editorial by a well known informaticists about the registry published
Looking forward to more in the coming year – conferences, presentations, publications.
Share this:Editorial on Secondary Use of EMR Data
December 2, 2010
As a follow up to the recent article on the Cleveland Clinic Chronic Kidney Disease Registry, there is now an accompanying editorial by William Hersch of Oregon Health Sciences University titled: Electronic Health Records Facilitate Development of Disease Registries and More. He states, “Their study shows that the quality of data in the registry is comparable to that of the data that would come from a much more labor-intensive and expensive process of human abstraction. This registry will be used for quality improvement, clinical research, and other important tasks. ”
He also makes good points about the importance of CPOE in the process as well as the benefits of secondary use or “reuse” of data.
Share this:Secondary Use of EMR Data
December 1, 2010
Part of the value of EMRs is the secondary use of the rich clinical data. Quality studies are an obvious win. This week, a new article by Kaiser Permanente Medical Group used this data in one of several registries to analyze 80,000 Total Joint and 5000 ACL Reconstruction Procedures in the Journal of Bone and Joint Surgery. The data was collected “through standardized documentation at the point of care” and “supplemented with existing administrative data from our electronic health records and other independent databases.” See the registry database structure here.
Also published this week is a second article from the Cleveland Clinic Chronic Kidney Disease Registry regarding the eGFR definition. This is another example utilizing these registries with secondary data for addressing significant issues in medicine.
The HIMSS 2011 conference will feature a symposium on secondary use of data as well.
Share this:The Future of Coding
November 30, 2010
In Wired magazine this month, Clive Thompson talks about his own experience in developing a mobile app. Coding for the Masses is the new reality. In a way, many in the Web 2.0 world have been doing coding by creating blogs, wikis, communities such as Ning, with little or no technical training. Now tools for mobile apps allow for building tools for the handheld devices. He notes Scratch to Google’s App Inventor as the enablers of this new reality.
Related is the book Program or Be Programmed by Douglas Rushkoff. The same concept of empowerment comes through. More once I read the book. Implications for healthcare? Obvious – epatients going beyond advocacy to become app developers. Physicians and nurses developing apps for their own use or for their patients. Check out this post about creating a journal club with Google Reader and Facebook. Not mobile yet but maybe for the iPad?
Check out the HIMSS HIT X.O conference track which include HIT Geeks Got Talent? contest – live programming. I was on the planning committee for this innovative program track.
Also, from Wired magazine check out the redesign of medical test reports.
Share this:EMR Article Gets Positive Press
November 8, 2010
The article I coauthored in the Clinical Journal of the American Society of Nephrology, Development and Validation of an Electronic Health Record–Based Chronic Kidney Disease Registry, received a nice press release from the American Society of Nephrology which was picked up by both medical and health IT news sources:
- Medscape: CKD Registry Could Help Physicians Improve Patient Care
- Healthcare IT News: EHR-based registry could transform chronic kidney disease care
- Healthcare Informatics: ??????Study: Kidney Disease Registry Could Help Patient Care
Blogs:
- Science Centric: Health registry could transform chronic kidney disease care
- Drugs-Expert: Chronic Kidney Disease Care Could be Transformed by Health Registry
I think that this registry is a model for others which utilize EMR data to study disease and potentially transform care.
Share this:Personal Trifecta
November 4, 2010
One of the advantages of having a personal blog is not only expressing one’s opinions but also promoting accomplishments. I have been fortunate to have three in recent months:
- coauthorship on a major article on a disease registry from EMR data - Development and Validation of an Electronic Health Record–Based Chronic Kidney Disease Registry, Clinical Journal of the American Society of Nephrology, Nov. 2010. Press Release:Health Registry Could Transform Chronic Kidney Disease Care
- named in an NIH grant: Refinement and Enhancement of a Web-Based Risk Calculator Deployment System
- named a Fellow in the Health Information and Management Systems Society (HIMSS)
Also, I became a fellow in the Group for Information Resources of the American Association of Medical Colleges this summer and reviewed a grant for a Dutch organization. Great opportunities and challenges keep coming. A great year.
Share this:Innovation Summit – Obesity, Diabetes & the Metabolic Crisis
November 2, 2010
This week I attended the Cleveland Clinic Innovation Summit and contributed to the live tweeting of the event. There was substantial discussion of devices in the pipeline and drugs for diabetes but a less optimistic outlook on drugs for obesity with some being shut down by the FDA. The most scientific yet controversial presenter was JefferyFriedman, who referred to his 2009 Newsweek article on “The Real Cause of Obesity” as a summary of his position that most of obesity is genetically determined. Many referred to the recent prediction posted by the CDC that the current incidence of diabetes being around 10% of the population with the potential of growing to 20 – 30% by 2050.
At the end of day two, the annual announcement of Top 10 Innovations. The final day will include health IT interventions for obesity and diabetes.
Share this:Health Care is Coming Home
October 28, 2010
In the New England Journal Journal of Medicine this week, a perspective article by a Cleveland Clinic physician, promotes the future of home care. Dr. Landers notes five major forces driving healthcare to the home.
1. Aging of the population
2. Epidemics of chronic disease
3. Technological advances
4. Health care consumerism
5. Escalating health care costs
In the conclusion of the article, he notes this as a long term trend perhaps taking decades. My view as a technology optimist, is that the combination of these forces will result in a faster pace of change with high tech home care being an integral part of the medical home.
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