I wouldn’t normally devote a whole blog post to one feature of Mac OS X Leopard, but this one really deserves it.

Data detectors is a huge innovation and something I would love to see in all kind of systems. The blog below beat me to laying out how they work. They really are incredible, though. Imagine having these in an electronic health record, where an abnormal finding or the result of a patient’s entry into a health risk appraisal could be detected automatically and advise on next steps based on evidence.

Marc Liyanage - Blog - Mac OS X - Leopard: Data Detectors - Awesome!

• The Changing 20s - Brookings Institution - Information / data about being in your 20’s in the 2000’s
• Lean Manufacturing Blog, Kaizen Articles and Advice | Gemba Panta Rei - Toyota places emphasis on facts learned at the Gemba.
• Life as a Healthcare CIO: The Tyranny of the Urgent - John Halamka, MD, posts his 1 year and 5 year plan on his blog. Way to be transparent.
• Modern Healthcare Online: Patient Safety Institute Closes Its Doors - YAR (yet another rhio….)
• CDC Reports Rise In EMR Usage - Slightly more physicians are using comprehensive EMR’s - but still at 12%

Our first new Co-Author is Mark Groshek, MD, from Kaiser Permanente, Colorado. He’s a leader nationally in tackling one of the most interesting issues in PCHIT, adolescent care. His first post follows this one and he will be a regular contributor about his experiences.

This blog is an experiment. It’s the chronicle of a journey of discovery around patient centered health information technology. Josh Seidman and I have been witnessing experiences at the practice level in health care organizations and talking about them here. This blog is not about Josh and Ted’s journey, alone, though.

What we also wanted to do was have the organizations themselves talk about their own experiences over time, with us. Therefore, as I have gone to each site, I have asked for a volunteer leader from each to blog with us. The leader can be a physician, nurse, any care provider. It can be a patient. This is a person that would talk about their experiences supporting patient-centered health information technology - including Personal Health Records and Information Therapy - the good times, the we wish things were better times, and the “what do we do now?” times. This is the benefit of the blog platform - it is not good at describing perfection - it’s great at describing a little bit of improvement every day.

Why do this?

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Charles Milligan, Jr., is the Executive director of the Center for Health Program Development and Management, University of Maryland, Baltimore County. I have to insert here that Chuck is also an alum of the University of Calfiornia, Berkeley School of Public Health…

The Center’s Mission is “…to work with public agencies and nonprofit community-based agencies in Maryland and elsewhere to improve the health and social outcomes of vulnerable populations in a manner that maximizes the impact of available resources,” and Chuck brings his experience here as well as experience supporting diverse populations in California in the areas of health care law and policy.

Chuck stimulated a very key conversation that resulted from a little confusion of my part (as I have now surmised). We talked about “PDCA cycles” and the idea that in the Toyota Motor Company, 80% of time is spent on planning, 20% on execution, the opposite of some American Companies. In our discussion these concepts seemed at odds, because as Chuck pointed out, policy makers benefit from quick movement from planning to execution so that they have something concrete to work off of.

Chuck also provided guidance on consumer involvement, that as we look to readily available sources of input, we should also look for not-so-readily available sources of input, because community boards and the like may not be truly representative in every case.

As Maryland’s leading public applied research organization for Medicaid Managed care, the Center is working on appropriately adjusted outcomes measurements that support reimbursements, or as Chuck stated, “report cards that are fair.” His group is also working on an electronic health risk appraisal and the impact on utilization before and after.

With UMBC itself, Chuck alerted us to a forum on behavioral health issues on campus, that will touch on issues of confidentiality and safety, which will happen on November, 27.

The Adjust: I couldn’t wait to resolve the issue regarding “P” from PDCA and “Planning,” and referred that question out to some experts in the LEAN world, which is detailed on the DailyKaizen blog in this post. The adjust, therefore, is in my opinion to keep going by rapidly improving what we do, and the 80% time planning spent happens in the P, C, and the A parts of the cycle. In that respect, Josh and I are doing regular checks on what we are doing. I am also working on setting up a visual system for the work (I will post the picture here, of course).

Chuck is one of the experts on our group regarding reimbursement and care of vulnerable populations, so as with other members of the group, we would like to check on what is happening in this arena. We are already doing that a bit based on the guidance by working to arrange discussions with payers in communities we are visiting. We did this in Boston, and are working to do this in California, our next stop.