Posts Tagged ‘employment’

DC Job Opening : Support the development of national health policy on behalf of the medical groups of Kaiser Permanente

February 22nd, 2010 | Popularity: 4%
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DC Job Opening : Support the development of national health policy on behalf of the medical groups of Kaiser Permanente – I was asked to pass this on, which I am happy to do; it's an open position in the Washington, DC, office of The Permanente Federation. The job is Director, Public Policy and Government Relations, and as the title says, is for a talented individual with experience in the health policy arena and the desire to support the excellent care of Kaiser Permanente physicians in our nation's capital.

Click on the link for more details, and just in case, the job # is 012631. I am not the hiring authority; however I can pass questions on and/or feel free to post your resume at the site above for consideration.

Top 50 U.S. places to work (Kaiser Permanente is one of them) + Holiday gift from DC : Equality

December 16th, 2009 | Popularity: 5%
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A few pieces of good news:

Kaiser Permanente is in the Top 50 U.S. places to work. It’s at #38, Apple Computer is #22. Not bad. Both Kaiser Permanente and Apple Computer also are on the list of employers that score a perfect 100% on the corporate equality index.

Washington, DC is joining the ranks of communities that provides equality to its residents, in the DC Council action yesterday to provide equality in marriage, expected to be signed by law by the Mayor, and not expected to be blocked by Congress.

In encouraging a colleague to blog the other day, I was asked, “How much of your personal life do you include in your blog?”

My answer to this is that I post things that are relevant to the three major things that are part of my professional existence:

  • Health (as a means, not an end; of people, family, community)
  • Diversity
  • Washington, DC

So this information counts as bloggable. A great employer and a diverse community are good for health and happiness. Enjoy, and congratulations to Kaiser Permanente and the District of Columbia. I’m glad I know you.

Now Reading: Articles challenging “Do happy employees = happy customers?”

May 11th, 2009 | Popularity: 20%
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I used to spend a lot of time struggling with this question, and I see many people still struggling with it, especially in Health Information Technology. I see a focus in a lot of places on making sure physicians are happy in order to be successful. The struggle is normal, this is a controversial idea. This article from HBR says that it’s the E=MC2 of customer loyalty.  

I’m not sure I agree, though.

I last did some deep-dive business study research on this a few years ago and came to the conclusion that patient happiness and doctor happiness are probably co-mingled. My work experience in several places has always worried me that excessive focus on the happiness of one population (doctors, nurses, allied health, anyone) puts patient happiness at risk, so why not just focus on their satisfaction as the key to everyone else’s?

In the article Employee Happiness Isn’t Enough to Satisfy Customers , the authors state:

The idea that employee satisfaction simply rubs off and benefits the company is wishful thinking.

And then go on to state that there’s no evidence that satisfied employees equal satisfied customers.

In the feature article, What Only the CEO Can Do, A.G. Lafley, chairman and chief executive officer of Proctor & Gamble notes throughout his interest in customer satisfaction first, in crafting the role of the CEO (much of it based on Peter Drucker’s philosophy)

Drucker also wrote that the purpose of a business is to create a customer. P&G’s purpose is to touch and improve more consumers’ lives with more P&G brands and products every day. Of all our stakeholders, both outside and inside, the primary one is the consumer.

And

As for employee stakeholders, we believe that P&G people are the company’s most valuable assets. Without them we would have no P&G brands, no P&G innovation, and no P&G partnerships. However, putting employees ahead of external stakeholders, especially consumers, would result in a more internal—and, arguably, more short-term—focus. P&G people are inspired by the company’s purpose and motivated by how they can personally touch and improve consumers’ lives.

In the article, Lafley talks about how the CEO shapes values and standards, and how in his role, he shifted the values more toward placing the customer’s needs first, as he felt that values prior to his tenure had evolved to place employees’ needs ahead of consumers. It’s an interesting read throughout to discover how the metrics of P&G are based on customer loyalty and penetration of P&G satisfaction into consumers’ homes.

I like articles like this because they connect the philosophies of some of our best health care organizations, like Mayo Clinic, where it is said,”The best interest of the patient is the only interest to be considered.”

I connect all of this to working with physicians through the understanding that physicians are passionate about helping patients succeed and often put this success ahead of their own emotional success, because they will do whatever it takes, however inefficiently or indirectly they must do it in the systems they work in.

If I/we can allow them to fulfill their passion, to support patients where they live, work, and play, in being successful, as efficiently and directly as possible, their emotional success will ensue, or as it said the Employee Happiness article,

…engage employees by giving them both reasons and ways to please customers; then acknowledge and reward appropriate behavior.

So I know this is a controversial idea, and my research may not be as deep as anyone reading this post – I welcome your comments.


Now Reading: Does Diversity Pay? and Defining the Attributes and Processes that Enhance Effectiveness of Workforce Diversity Initiatives

September 16th, 2008 | Popularity: 31%
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The answer to the question in the post title is Yes.

In the last year or so, I have been challenged and challenged myself personally to understand the impact of workforce diversity, and these scholarly works helped a lot to understand it better. The impact is significant.

The first paper was written by Cedric Herring at the University of Illinois at Chicago and widely reported, both on NPR and in the Washington Post. It is a well-done regression and factor analysis of 251 for-profit business organizations’ performance dependency on racial diversity.

As defined in the paper:

Diversity is an all-inclusive term that extends beyond race and gender and incorporates people in many different classifications. It includes age, geographic considerations, personality, culture, sexual preferences, tenure issues, and a myriad of other personal, demographic, and organizational characteristics. Generally speaking, the term Aworkforce diversity refers to policies and practices that seek to include people within a workforce who are considered to be, in some way, different from those in the predominant group. In the 21st century, workforce diversity has become an essential business concern.

The paper represents a first-of-its kind analysis in that it controls for organization size, region, and age (with the idea that larger organizations typically have more racial diversity in them). And all of the tested hypotheses are statistically significant in the affirmative:

  1. The more racial workforce diversity a business organization has, the greater that business organization’s sales revenue will be.
  2. The more racial workforce diversity a business organization has, the more customers it will have.
  3. The more racial workforce diversity a business organization has, the larger market share it will have.
  4. The more racial workforce diversity a business organization has, the greater that business organization’s profits will be relative to its competitors

The second scholarly work is about the attributes of effective diversity initiatives. Not surprisingly, one of the cornerstones of effectiveness in this area is leadership, and leadership at the executive level. The intermediate outcome, that leads to the important outcomes above are the creation of an organization whose “population of underrepresented minorities experience the firm climate as being open to diversity and feel as if their race will not hinder them from career progression.”

Why is this important?

People like me are interested in the topic of diversity and disparities because we want to grow, learn, and do better every day. We also want to be in environments where we can succeed by performing well for the people we serve. Data shows that most people prefer to live in diverse environments. This information promotes the idea that people probably prefer to do business with organizations that create diverse environments. The data support the idea that leaders who are truly interested in organizational performance are interested in supporting diverse environments.

As mentioned in the second paper, the world’s best companies understand this:

Several Fortune 500 firms (e.g. IBM, Verizon, Pepsico, GE) have experienced sustained success in their efforts to recruit and retain a diverse workforce, making these firms exemplars in diversity management and ripe for future empirical research.

Why is this important for me?

Around the time that this blog post appeared, I was sitting in a Seattle Metro bus on the way home, in one of the front seats, looking at a poster of Rosa Parks placed overhead, celebrating her accomplishments. It was right after Martin Luther King, Jr’s birthday. I knew that in a different time or place, even in 2007, that I’d be sitting in one of the seats in the back. More importantly, those who would come after me would also be asked to sit in the back, if I did not make a sustained commitment. I realized at the moment that there’s a lot of good news out there – so many organizations have made clear commitments to diversity, and are able and willing to hire the best talent regardless of background. Those are the organizations I will always be a part of.

And yes, Kaiser Permanente is one of them.

(see: Kaiser Permanente’s score in the Corporate Equality Index (score: 100%)).


Learning

September 15th, 2008 | Popularity: 13%
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I am continuing my ongoing orientation process and was helped today with this explanation of the role Permanente Federation. I wanted to post it in my Twitter feed, but it’s longer than 140 characters. I guess that’s what I need to get next….

The Permanente Federation is a small group of dedicated physicians and staff who support and help and coordinate the work of 8 Permanente Medical groups across the United States.

In Bisnow on Business: Washington DC Local Medical News

September 10th, 2008 | Popularity: 20%
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What docs should read: Washington DC Local Medical News

(I’m below the fold)

A dream realized: Made it into Bisnow on Business: Washington DC Local Medical News: WHAT DOCS
SHOULD READ
. Now I’m really a Washingtonian, complete with driver’s license and taxpaying privileges.

I must say, in the background of the humorous sarcsasm of the corporate shackles comment in the article: Employed, Unemployed, what does that mean anymore in the context of ideas like the Results Only Work Environment, in a city where people work to improve the health of the nation in a diversity of ways, as part of a generation that challenges the importance of organizational affiliation?

I’ve been working this whole time and learned a ton, online and offline – and one of the things I’ve learned is that this is not dependent on being in a big company, or a company at all. It’s what you do for people and how you learn to be better at it every day.

Shackled or not (mostly not), this is a great community to be a part of and I am honored to support it along with all of the others profiled by Curtis and the Bisnow team. Keep up the great work!

More Hospitals Begin To Pay Physicians for Health IT Input – iHealthBeat

September 6th, 2008 | Popularity: 17%
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Now Reading: “Why Work Sucks and How to Fix It: No Schedules, No Meetings, No Joke–the Simple Change That Can Make Your Job Terrific” (Cali Ressler, Jody Thompson)

August 25th, 2008 | Popularity: 49%
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As a leader in an organization, imagine reading this description of an employee’s workday:

A typical day for me includes waking up when my room is too bright from the sun and I can no longer sleep. I check my e-mail to make sure there are no pressing issues and respond to anyone who needs my input. I will typically watch an episode of South Park on the Internet, then walk to my local grocery store and buy some breakfast, even though it’s closer to lunch at this point. After eating I will work in front of my television with ESPN on in the background. At this point I will choose to go into the office or continue to work from home, or maybe not even work at all and go for a bike ride or jog. If there is still work to do later that night, I’ll do it then and it’s no big deal.

I’ll admit it – it kind of made me gulp when I read it.

At the same time, though, I have been in a lot of conversations with a lot of personal and professional colleagues over the past 3-4 years or so, where the question we’re asking ourselves is, “Is this how work life is supposed to be?” Spoken or unspoken, the answer is “we don’t think so.” Various companies’ data also show a trend toward less vacancy in their physical locations.

In the middle of that self-discovery, I read about BestBuy, Inc., (see “Smashing the Clock“). This is the book about their journey.

It’s time to let go and see what our employees can really do – BestBuy Manager

A Results Only Work Environment (ROWE) is as it says – one where results are measured, not time spent. There are no timeclocks, no discussion of time, and no “Sludge” as the authors refer to it. “Sludge” are the comments people make to each other about time, whether it’s about being late to a meeting, or working late at night. Simply put, the authors state, an employer is trading work for money. Why not give them what they pay for?

Reading beyond the BusinessWeek article was very useful – this is not flextime, it’s not “working from home,” it’s a different philosophy altogether. That includes the vignette above. Totally allowed, if you have the results to show for it. The concept can appear challenging; however, it makes sense, in the context of strong leadership committed to respecting employees and customers. That’s where I found similarities to the work I have done.

About respect

When I first read about this work, I asked about how this was similar or different from the LEAN transformation I participated in, in the area of health information technology. Some of the things were consistent, some seemed less so, like having technology teams physically present alongside doctors and nurses, guiding care and feeding of an electronic health record system.

My reconciliation of all of this rests with not comparing individual tools/approaches between ROWE and LEAN. What they both have in common is respect for the customer and staff, and strong leaders. It’s impressive that at the heart of the ROWE movement was (at the time) a 24 year old employee of BestBuy (Cali Ressler), who was dissatisfied with the status quo. The authors also explicitly reject war analogies in business as I have. In my own situation, there was not just a desire to change the way we worked, it was clear that not changing would be unsafe. Healthcare organizations across the country are now learning this, thankfully, but it’s a slow transformation, and the transformations that are happening are nowhere near as radical as ROWE, which is why I am interested in the movement (not because I want to be radical, but because the threats to our patients and their families’ health are so significant).

Just because you can no longer be late doesn’t mean you can be lame

Preliminary data from the University of Minnesota’s Flexible Work and Well-Being Center are showing that voluntary terminations are down, involuntary terminations are up.

Mea culpa and, as usual, I see analogies to health care

I liked the concepts in the book a lot, and have done a self-inventory of my own sludge and the sludge that’s been directed my way. The kind of sludge I get nowadays is really from people who want to understand better how technology can be used to help patients stay healthy. I welcome it as an opportunity to teach and learn. As the authors discussed, people can learn to live sludge-free, and they really want to live sludge-free. It starts with us.

I could see myself promoting ROWE in health care settings, and I think physicians, primary care ones especially, would benefit. The work I do to change health care is completely connected to the idea that health is a means, not an end, and people who go into health care want to support our patients where support is needed, mostly where they live, work, and play. I don’t believe people in health care are any more attached to time than Cali and Jody’s (former?) colleagues at BestBuy are. When I read the stories of BestBuy employees before and after, I reflected on some of the conversations I have had with health professionals (at all levels) who have really been challenged to juggle their passion for helping people and their ability to provide for themselves and their families, physically and emotionally. What would it be like for a family medicine or internal medicine specialist to provide their cognitive services to patients and families using a combination of virtual tools and office (or even home presence) when the situation called for it? Look at what HelloHealth is doing. It’s possible.

A Results Only Patient Experience (ROPE)?

A came upon this table in the book, and curiously, I found it extensible to our health care system. I hope I won’t get in trouble for using it to think about what our health care system were like if our patients experienced it the way a BestBuy employee experienced their work life. The edits are mine.

ROPE.jpg


What Should Employers Do about Health Care? — HBS Working Knowledge

August 5th, 2008 | Popularity: 14%
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Creative Class » Blog Archive » Happy Jobs, American-style – Creative Class

August 1st, 2008 | Popularity: 16%
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Now Reading: "Nickel and Dimed: On (Not) Getting By in America" (Barbara Ehrenreich)

June 18th, 2008 | Popularity: 29%
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Last week, I was walking with one of my patient-centered mentors, David Sobel, MD, through one of my favorite museums in Washington, DC., The National Portrait Gallery. As I brought him to one of my favorite pieces, I asked him if he read this book, and he told me it was one of the most influential books he’s read. “Have you gotten to the Wal-Mart section yet?” he asked. I have, and I have to say I agree with his assessment.

This book preceded a more modern version of living among the corporate natives which I reviewed previously, Punching In, by Alex Frankel. Unlike Alex Frankel’s adventure, Barbara Ehrenrich goes completely native, adopting the lifestyle of a minimum wage worker, down to eating, living, and surviving (or attempting to) in several different American cities. Her jobs include being a server in several restaurants, a house cleaner for a large national franchise, and a stint in retail.

We learn some realities of these jobs – it’s never really okay to not always be doing something, even if there’s nothing to do. One of her places of employment calls this “time theft.” So there’s a constant flow to the work, some of it useful, some of it not. The profiles of her coworkers describes the conditions that the working poor must accept – not having first month’s rent and deposit may mean spending $60 a night in a motel, an irrational yet necessary way to survive. The quality of life that Ms. Ehrenrich accepts for her assignment is concerning bordering on dangerous – a single woman in an efficiency with no screen on the window on the ground floor.

As I read this with an interest in employer-based health, I also learned a lot.

» Read more: Now Reading: "Nickel and Dimed: On (Not) Getting By in America" (Barbara Ehrenreich)

iCareerChange

June 8th, 2008 | Popularity: 24%
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Once In a Lifetime Talking Heads

“And you may ask yourself, how do I work this?”

It has become fashionable to say farewells in person, over e-mail, and now in the blogosphere. Since the e-mail has already gone out to all of the staff at Group Health Cooperative, this is my blog farewell. I have decided to leave my position as Medical Director of Health Informatics and Web Services; my last day with Group Health Permanente, providing direct service to Group Health Cooperative, will be June 30, 2008.

Without realizing it, I wrote a little tribute to my wonderful experience as a Group Health physician and patient empowerment advocate in my book review of “Overtreated,” by Shannon Brownlee. I definitely share the feelings of another blog farewell I read along time ago – I leave with gratitude and appreciation for every Group Health member and staff member who supported me in becoming a better physician and servant leader every day. I was rebooted often, and reprogrammed/upgraded regularly by these awesome teachers.

People who know me know that the glass is at least 3/4 full. Fortunately, Group Health is a great place to be optimistic about improving the health of patients and their communities. I’m certain that health care across the United States and beyond has been improved through Group Health’s contributions; the innovation that will continue to come from Group Health will also continue to help every patient in every care system.

Keep in touch, Group Health, and all the best.

No Schedules, No Meetings—Enter Best Buy’s ROWE – Part 2

June 2nd, 2008 | Popularity: 16%
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The CMIO–A New Leader for Health Systems — Leviss et al. 13 (5): 573 — Journal of the American Medical Informatics Association

May 29th, 2008 | Popularity: 21%
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Beyond Blogs : Businessweek

May 26th, 2008 | Popularity: 16%
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  • Beyond Blogs : Businessweek – A refresh of Businessweek's landmark 2005 story about Social Media and businessweek. Interesting update: prediction of mass firings of employees who blog (being "Dooced") has not happened, with the exception of a few well publicized cases, like this one. Perhaps Web2.0 is subtly changing the expectation of transparency on the part of organizations and their customers – participation is becoming more of a norm.

Giving a great presentation from Al Gore; Genie Industries LEAN approach; Wisdom of Patients Paper

May 7th, 2008 | Popularity: 55%
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The Genie Industries video is especially compelling because everything they discuss is applicable in health care. What if we substituted “patient care” for making scissor lifts – we would see huge strides in improvement. Also, just upgraded the software that powers this blog. Viva open source.

Learning More About the Medical Home and Finding Innovation Where It Lives

April 16th, 2008 | Popularity: 55%
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If you are interested in innovation, I think this is a good podcast worth listening to – and the actual audio is more useful than the printed version.

I listened to it the day before I attended the latest Patient Centered Primary Care Collaborative, in Washington, DC. At the meeting, I was fortunate to run into one of my role models, Susan Edgman-Levitan, PA, and we talked about the idea that the Medical Home is about improving the care of patients where they spend most of their time – where they live, work, and play. We can help patient-centered care flourish by including ideas from everyone involved in the care, including nurses, doctors, allied health practitioners, eye care, oral health care, behavioral health care, just to name a few.

I liked what Jack said in the podcast, that in a company, there has to be

a sense that in every soul of the company, the idea that everybody innovates.

Toward the end of the podcast, Jack gets quite fired up about the idea that innovation can’t be regulated to the chosen few. My experience reinforces this. In the area of health information technology, this is critical. When most people think about implementing HIT, they think about the implementation period. The most powerful part of HIT is what happens after implementation, and using a management system like the one developed by Toyota Motor Company (as we are) can allow an organization to turn HIT into an organization wide innovation engine – if they capture all of the ideas of everyone involved in providing care and put them to use. To not do so is to waste one of the most valuable raw materials for growth – ideas and time (and most importantly our patients’ time).

One other conversation that has come up in the last several days is about generational changes in approach. Many of the Generation X and Generation Y colleagues I have been talking with were raised in a professional environment where we were not going to have all the answers, and we are uncomfortable being accountable for them. We want to share the power of coming up with the answers with our provider colleagues and our patients. This is not to say that our baby boomer colleagues don’t have this desire, too. I think we are stimulating each other to do what they’ve always wanted to do, and involving patients, their families, and all practitioners, all specialties and roles, is really going to make a person’s medical home special.

Feel free to take a listen and let me know what you think:

Finding Innovation Where It Lives

The Mission of Southwest Airlines

April 11th, 2008 | Popularity: 15%
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From The Mission of Southwest Airlines. I flew Southwest from Oakland to Ontario yesterday, and I was impressed with the CEO’s apology in the Spirit magazine about recent events concerning Southwest’s maintenance policy. I was reminded of the mission of Southwest, which I admire so much, specifically the second part.

The Mission of Southwest Airlines

The mission of Southwest Airlines is dedication to the highest quality of Customer Service delivered with a sense of warmth, friendliness, individual pride, and Company Spirit.

To Our Employees

We are committed to provide our Employees a stable work environment with equal opportunity for learning and personal growth. Creativity and innovation are encouraged for improving the effectiveness of Southwest Airlines. Above all, Employees will be provided the same concern, respect, and caring attitude within the organization that they are expected to share externally with every Southwest Customer.

January 1988

Physicans and Blogs; Explaining the RUC; Nice Use of Second Life

March 22nd, 2008 | Popularity: 39%
4 comments

March 18th through March 19th:

  • The ‘World Wide Computer’?Another HAL? – Businessweek’s Review of “The Big Switch” – I used it for comparison
  • NPR: Doctor Blogs Raise Concerns About Patient Privacy – I agree with points raised – a patient should never seek care and then discover that they have been written about on a blog. Instead, they should receive a copy of the medical record that has been created about them. At the same time, physician bloggers are doing something very important – they are testing the boundaries of transparency, to support a more accountable health care system. If anyone saw the 60 minutes story about Dennis Quaid and his family, the rationale for this become very clear.
  • What Every Physician Should Know About the RUC – January 2008 – Family Practice Management – The information is useful. As primary care providers I think we need to be careful to include our specialty colleagues in the conversation, not distance themselves from it. As a member of a large multispecialty medical group, I know that there is interest across the physician community in supporting community health and the best experience for patients.
  • MindBlizzard blog: Virtual Healthcare 2: Palomar Pomerado Health – All right – More news about the utility of Second Life – testing a hospital before it launches
  • What is the ROI on employee suggestion systems? – A nice example from the toothpaste industry. But not necessarily one that supports the evidence, that far less toothpaste than people think is needed to protect teeth…..Maybe a customer suggestion system might be in order.

Microsoft opens up; Illustration of Chartjunk; CNN fires an employee who blogs

February 25th, 2008 | Popularity: 31%
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February 23rd through February 24th:

History of Airline Marketing; Going Pharma-free for CME; Closed-Journal Publishing

February 21st, 2008 | Popularity: 44%
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February 15th through February 16th:

The first few links are from the history of diversity in various industries’ and their impact on quality, affordability, and safety.

Now Reading: Working the Skies, by Drew Whitelegg

February 19th, 2008 | Popularity: 25%
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It was interesting to juxtapose a book about the ideals of a profession (See: Now Reading: A Fortunate Man) with one about a profession in transition. “Working the Skies” is about the world of the flight attendant, and in contrast to “Femininity in Flight,” is more about the contemporary world of flight attendants, told from their perspective.

That story is one about a job that was created as a temporary assignment and then grew up to be a profession in an industry that has both high emotional significance to society, and that struggles every day.

» Read more: Now Reading: Working the Skies, by Drew Whitelegg

Better walking in DC; BIDMC going LEAN?; CEO Blogging; Best Companies 2008

February 7th, 2008 | Popularity: 71%
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February 4th through February 6th:

Promising Reimbursement Methodology; More on Music and Real Estate Industries; Another Blog Post Goodbye to an Employer

January 15th, 2008 | Popularity: 45%
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January 12th through January 13th:

  • Prometheus Payment, Inc. – A new payment model that supports outcomes, evidence-based care, and transparency
  • The music industry | From major to minor | Economist.com – “Then they had the money and could have built the competence by buying concert agencies and merchandise companies,”…Now it may be too late.
  • Coverity Incorporated Scan – Company working with the US Govt to harden open source code for use by agencies including Homeland Security. They are finding bugs and the bugs are being fixed.
  • Online Real Estate Sites Work To Get A Listing Standard – Another industry that is seeing the benefits of standards, and the challenges of disruption
  • Gone Indie ? Thought Palace – Interesting insight on the work environment at Apple. LEAN production? You decide. I will say, though, that even though Apple is not embracing Web 2.0 like other companies are, I have solved many problems using their hosted discussions. These actually work well on Apple’s site I think because they do a great job of leveraging their loyal customer base. Yet another blog “goodbye” to an employer.
  • Lean Manufacturing Blog: 1 Hour Kaizen – Excellent template and approach to small improvements. Just takes an hour. Can we have physicians shadowing nurses and vice versa?

How not to lead Geeks; Being a Chief Inspriation Officer

January 10th, 2008 | Popularity: 49%
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HIT Resources; Blogging about “breaking up” with your company; Dr. Phil (Marshall) joins the blogosphere

January 7th, 2008 | Popularity: 28%
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Industry Disruption; Managing Information using Web2.0; Jobs and Portability

January 2nd, 2008 | Popularity: 35%
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I’m starting to track the disruption of other industries, like music and real estate….

December 29th through December 31st: