Posts Tagged ‘innovation’

Photo Friday: Notice the Creativity and Innovation Around You (snow couch)

February 19th, 2010 | Popularity: 4%
0 comments | Leave a reply

Snow Couch - Dupont Circle

I knew this had to be this week’s photograph the minute I saw it (and cross posted it in various places…). It is what it looks like, a beautifully created couch made out of snow, in Dupont Circle, Washington, DC. This is just the tip of the iceberg reminder of what comes from a community that embraces diversity and new ideas.

Not everyone lives in/works in a place that is brimming with or tolerates diversity (ahem, Virginia), so the creativity and new ideas may not be as apparent, but they are there. I think people should always stop to notice them – creativity, innovation, and diversity potentiate each other.

Here’s a view of the furniture from different angles. Enjoy.

The War on Interruptions, an Excerpt from “Switch: How to Change Things When Change Is Hard”

February 8th, 2010 | Popularity: 3%
0 comments | Leave a reply

The War on Interruptions, an Excerpt from “Switch: How to Change Things When Change Is Hard” – A discussion of innovation created at Kaiser Permanente around medication dispensing in the hospital. A lot of the innovation that may happen in organizations who have completed rollout of electronic health records may not be a new piece of software or more programming. Great validation of design-thinking.

Photo Friday: Kaiser Permanente Colorado Springs

November 22nd, 2009 | Popularity: 5%
1 comment

Kaiser Permanente Colorado Springs

This week’s photograph is of one Kaiser Permanente’s newest medical offices, in Colorado Springs, Colorado. In addition to this photo, I’m posting two panormic views, of the Briargate Senior Center (above) with Memorial Hospital Across the street, and one of the scenic viewpoint from I-25. There are some views of the interior of the new facility below.

If you’ve been to the Sidney Garfield Center for Healthcare Innovation, you’ll recognize that the work done there in the health care environment is now real for patients, nurses, and doctors.

This medical office, as you might expect, does not have any space for paper charts or x-ray films – medical record and imaging information is captured digitally, allowing for more space for patient care.

Colorado Springs Panoram

Colorado Springs Panoram

Gemba Walk: Kaiser Permanente Colorado

November 17th, 2009 | Popularity: 5%
3 comments

Finally, the opportunity to shadow one of my favorite physicians, Paulanne Balch, MD! This is her in her practice environment, at Kaiser Permanente Hidden Lake Medical Office, near Denver, Colorado. I’ve known Paulanne for at least 6 years, but have never seen her practice. I think this fills out the knowledge of who a doctor is – seeing how they care for patients. And as expected, I was impressed.


Paulanne Balch, MD

My visit to Paulanne is part of a visit to innovative medical practices in the Kaiser Permanente, Colorado Region (now with it’s own Twitterfeed in 2009: @KPColorado). I happen to have come at at time full of pride for KP Colorado, as they have just been named the #1 Medicare Health Plan in the United States, which makes them the best for customer experience, prevention, and treatment, as measured by NCQA.

We're in the top 10

Actually, it’s top 1 ….

And…the practices that I have been visiting are demonstrating how KP Colorado got there. As I have written previously, it’s remarkable to watch clinicians in this system, who have been using a robust electronic health record linked to a robust personal health record (at kp.org) for over 2 years now. There is good understanding of the advantages of being electronically connected to patients and to each other, as well as a continuous drive to leverage these systems to their fullest potential (and maybe beyond what they can handle, even in 2009).

I was also able to shadow Kathy Mayer, MD and Michael Pate’s practice at Kaiser Permanente Southwest Medical Office in Denver. I have mentioned this practice previously, as one that is known inside and outside of Kaiser Permanente as one with a very well formed team approach to caring for patients. And, as the rankings reflect, they have great quality results. In a mature EHR environment like this, support of whole populations of patients is possible, no more hoping that a patient will come in and have their preventive care performed. In fact, as I was there, Dr. Mayer completed identifying the last few patients on her panel that did not have necessary preventive care performed so that they could be contacted to be up to date.

I plan to be here for a few more days, to see more practices in different parts of the region, and to learn about several innovations and potential innovations in care that are being developed here. I also did something new this time, by inviting colleague Jan Ground, a project manager from Colorado Permanente Medical Group, to shadow with me. We have been able to compare notes on what we see, and Jan has been able to contextualize what I have been seeing as someone aware of the operations here.

The most important thing, though, is that we are seeing things at the level of the patient, the highest level there is in health care.

Here are some more photos of our journey – Denver is enjoying the aftermath of a snowfall earlier this week….

Innovation Learning Network : The Care Anywhere Tapestry

November 2nd, 2009 | Popularity: 3%
0 comments | Leave a reply

As I mentioned last week, I was impressed by the Care Anywhere concept being developed within the Innovation Learning Network.

Why? Because it describes a host of activities that organizations can embark on to empower patients where they live work and play. The projects are not tied to a financing model or a certain organization, which makes the tapestry appealing not to me, and hopefully to you, too.

This is a pre-release copy that the ILN is allowing me to post here. Enjoy

Innovation Learning Network In Person Meeting – Boston

October 28th, 2009 | Popularity: 4%
2 comments

I enjoy participating in the Innovation Learning Network because it brings parts of health care and other industries interested in the improvement of the art, science, and technology we use in health care rather than in those things themselves.

Plus the people are great; and I don’t mean “great to spend time with,” I mean challenging to me in ways that gently reboot the kernel here and there. One of my favorite quotes is from Marilyn Chow, RN, DNSc, FAANVice President of Patient Care Services.

Innovation is the ability to observe and think

Care Anywhere, my second look

Unlike the last meeting which was held at the Steelcase Learning University, this one was more inwardly focused, on ourselves. And, away from the glow of Steelcase Nurture, I got a second glimpse of CareAnywhere, which is a cross-organizational concept this group has been developing over the past two years.

A nice definition has been created:

Care Anywhere exists to help me live to my fullest, on my terms by providing ubiquitous access to my health information and providers in order to maintain my health where I live, work and play.

Around the concept, a tapestry has been created, which has been filled with the innovations of several member organizations.

And guess what, a lot of them aren’t Kaiser Permanente projects.

I like this a lot. It helps with the “only Kaiser Permanente can do that (deliver care where patients want it)” conversation (see my quote from Jack Cochran, MD, CEO of The Permanente Federation about that). It also creates a realistic framework for any organization to pull from in re-imagining that care doesn’t happen in a hospital, or even in a person’s home – “live, work, and play.”

I don’t have access to the URL’s of all of the projects I saw (yet), but here’s one – Hospital at Home, which originates from Johns Hopkins University.

UnConference within an UnConference – a conversation about professionalism

The Innovation Learning Network in person meetings are tied to the concepts of UnConferences or at least not-your-standard-conference, which are provocative, stimulating, attention-holding.

A few of us, however, unintentionally had an UnConference within the UnConference, where our continuous-partial-attention was not very continuous, not very partial, to the content at the front of the room. However, not less relevant to our passion to improving health care for patients.

We had an interesting conversation about what a physician is and what it means for them to be in a room of their “professional” peers. “Professional” is in quotes because there was some discussion about the expectations of physicians versus others. In a world where “professional peer” doesn’t equal “having an MD” any more, does this change?

I don’t know the answer to this question; it was good to hear the issue raised, though. Perhaps our friends at American Board of Medicine Foundation might have thoughts on this. Or not. I think of ABIM Foundation because I know they are developing a significant competency in the area of professionalism in medicine.

After the Innovation Learning Network meeting, we went into the CIMIT Innovation Congress, which kicked off in an auditorium. Now, one thing I learned at the HealthCamp SF Bay UnConference was, “don’t have attendees attend a regular conference the day after an UnConference. They won’t sit still.” And…it’s true.

Speaking of great people

I watch some of the most interesting people I know connect at this meeting, plus at least a few new Tweeters were born. Please welcome, and/of follow Paulanne Balch, MD, Lyle Berkowitz, MD, Jan Ground, Jeff Hall, Keith McCandless, and Danny Sands, MD, and, do a Twitter/Google search for the hashtag “#iln09″ to find more. The conversation doesn’t end when the conversation ends.


Zimmerman and Linton on innovation – Greater Greater Washington

October 16th, 2009 | Popularity: 2%
1 comment

Zimmerman and Linton on innovation – Greater Greater Washington – Caught my eye with the title; instructive in health care with regard to innovation (and the sharing of it) as well – “Getting a customer on that pays a fare to fill a bus that’s not full could be worth a lot more to us, potentially.”

In other words, the tension between being proprietary vs sharing may be reduced by the idea that sharing brings more business.


Walking in Patients’ Shoes: My Home Blood Pressure Monitoring Experience

August 18th, 2009 | Popularity: 8%
4 comments

Subtitle: Innovation comes in many forms!

Attached is a series of slides that recap my experience learning about home blood pressure monitoring, by trying it on myself, using an innovative device manufactured by Microlife Medical Home Solutions, Inc., called WatchBP Home. (Note: Please see my About page for my conflict of interest and independence statements)

The whole thing was a great experience in learning about the process, and learning about learning, as I tweeted my experience as I went. On that note, I discovered in putting this together that Twitter may not be the best platform, compared to a hosted blog, to use to store information that you want to retrieve later.

I overall think this is a great case study in thinking about innovation in medicine:

  • is innovation in home blood pressure monitoring in bluetooth connectivity and IP addresses?
  • Is it in design and coaching/guiding that empowers patients to monitor accurately and with confidence?

Of course the two are not mutually exclusive, but what’s the balance in health information technology right now? I wrote about this a bit at the last Innovation Learning Network in person meeting. Slides are below, see what you think. Comments and questions always welcome.

I’ve prepared a link cloud of scientific articles related to the device and home blood pressure monitoring in general, which you can view here.

With thanks to the team at Microlife for allowing me to enjoy this learning experience, and fellow patients Gilles Frydman, ePatientDave, and Jan Oldenburg, for a few gentle reboots of my thinking during my learning, enabled by Twitter!

If you’d like an embeddable version of these slides, you can get them here.

Photo Friday: In the Digital Operating Room / Seattle Panoramic

August 7th, 2009 | Popularity: 12%
1 comment

In the Digital Operating Room

I couldn’t choose a single photograph this week, so I chose two. The first is of myself in the “Digital Operating Room” at the Sidney Garfield Center for Innovation in Health Care , which I have written about previously (with an image of Jim Lewis, MD, from the Innovation and Advanced Technology Team, who’s been leading this work for Kaiser Permanente). The side by side image of the home environment (also in The Garfield Center) is a (theoretical) illustration of a future where there could be greater involvement of patients and families in their care, across the spectrum.

The second photograph is a panoramic and Quicktime Virtual Reality (Plugin required if you don’t have it: http://www.apple.com/quicktime) view of the Montlake cut in Seattle, Washington, on a gorgeous summer day this week. This week was a milestone for me in that I moved to Washington, DC for the second (and last) time, ending all of physical ties to the Seattle community (but not my emotional ones!).

Montlake Panoramic

HealthCamp SFBay – October 5, 2009 – Come Join Us!

August 5th, 2009 | Popularity: 11%
3 comments

Dear The Internet,

I wanted to give you the heads-up on a dynamic event in early October you may want to attend: The Accelerating Health Care Innovation “unconference” at the Kaiser Permanente Garfield Innovation Center near the Oakland airport.

Hosted by HealthCamp SFBay, Health 2.0 Accelerator and Kaiser Permanente, the event is 10 a.m. to 5 p.m. on Monday October 5, the day before the Health 2.0 Conference in San Francisco.

Accelerating Health Care Innovation is an “unconference” where peers in health care and technology introduce topics they want to present and discuss with the goal of advancing innovation of strategic, technical solutions in health care.

Among the participants and speakers are Dr. Kaveh Safavi, Cisco’s Vice President and Global Lead for Healthcare and Dr. Jack Cochran, Executive Director of The Permanente Federation.

Details & Background

HealthCamp SFBay is a gathering of software developers, technologists, doctors, nurses, innovators, designers and health care technology media who come together to talk about health care innovations.

Health 2.0 Accelerator is a consortium of Health 2.0 companies working together to advance consumer-centric health care by driving the integration of technology and the consumer experience.

The Kaiser Permanente Garfield Health Care Innovation Center (kp.org/innovationcenter) is the only setting of its kind where technologists, architects, nurses, doctors and patients collaborate to spawn innovation, brainstorm and test tools and programs for patient-centered care in mock hospital, clinic and home environments.

For a peek inside the Garfield Center, check out the audio and photographic slideshow CNET recently posted about it:

http://news.cnet.com/8301-11386_3-10265074-76.html?tag=newsEditorsPicksArea.0

Because the Accelerating Health Care Innovation event will sell-out due to limited tickets, early registration is recommended:

http://healthcampsfbay.eventbrite.com/

Free shuttles from BART are provided with details on the registration site.

Sidney R.Garfield Health Care Innovation Center
590 Whitney Street
San Leandro, CA 94577

I’ll see you there!

Best regards,

Ted

“Do you Ride?” – Learning about leadership from Harley Davidson in Oakland, California

July 30th, 2009 | Popularity: 11%
0 comments | Leave a reply
Harley Davidson dealership Oakland CA

Harley Davidson dealership, Oakland, California

I am back in Oakland, California, at the Sidney Garfield Center Health Care Innovation Center, this time supporting the Permanente Medical Group’s course “Medicine and Management,” which brings physician leaders from across the nation to learn about leadership in all of its facets. This includes providing great care experiences for members, recruiting and mentoring other physicians, and today’s installation of the course, techniques used in innovation.

In this morning’s session, there was a surprise trip to the Bob Dron Harley Davidson dealership in Oakland, California to learn about leadership in a context other than health care. By the way, I misspoke in my twitter feed that we were going to the Harley-Davidson factory – this is where we went, and it was no less impressive. One thing I really enjoy is learning about different ways of doing things from outside of health care.

The question in the title of the post was something we were asked by several of our tour guides – they would ask, “Does anyone here ride?” as a way to identify enthusiasts up front. Despite the fact that most patients wouldn’t call themselves enthusiasts of health care, there are (as with everything I see), parallels to health care. Although not enthusiastic about health care, I’d say most patients are enthusiastic about a great patient-physician relationship.

I was impressed by the level of interest in collaborating to create a good customer experience in all facets of the relationship – from the decision to purchase, to buying add-ons, to service. Because service is such an important part of the relationship, the service area is as clean and welcoming as the sales floor is (and service involves sales, too).

This part of the day was an introduction to observation, in the process of innovation. We were coached in asking useful, open-ended questions, and then went back to the Garfield Center to convert the observations into storytelling. We also did exercises in brainstorming (see photograph below) to acquire as many ideas as possible and sort through them.

Brainstorming Exercise - Medicine and Management Course
Panoramic view of Permanente physicians learning design thinking


Tomorrow, the group will continue to learn about the skills of innovation, or design thinking, led by the Innovation Consultancy group at Kaiser Permanente. The skills being taught to this group of physician leaders are the same ones used to develop the breakthrough MedRite program, which has changed the way people think about (and do) medication administration in hospitals so that it is safer. If you look at the tools used in MedRite, they are not new computers – using design thinking, the tools are simple, effective, and can be spread easily.

I am, of course, a big fan of continuous learning, and think it’s differentiating for medical groups to teach the skills of innovation. Through the work of the innovation consultancy, and more broadly, the Innovation Learning Network, Kaiser Permanente participates in sharing knowledge across organizations, just like our members expect.

More photographs, click on any to see larger size


Innovation Learning Network 2009 In Person Meeting – Learning Innovation in Healthcare

May 8th, 2009 | Popularity: 24%
6 comments

I am back from Grand Rapids, Michigan, site of the 2009 Innovation Learning Network in person meeting, at Steelcase University Learning Center . It’s a beautiful facility and a great place to bring some of our nation’s leading health care organizations and innovation experts together.

I was given the opportunity to attend by Kaiser Permanente to think about the place of innovation and learning about innovation in medical groups, and was not disappointed. I did not leave the meeting with the answer to the question, “how should a medical group (or any group of clinicians) involve innovation in their activities to learn to be better clinicians and deliver excellent care?” I did leave feeling that the question is important to explore, though.

First some specifics:

Our #ILN09 twitterstream shows what we did step by step. On the second day, we were treated to a closer look at the work of the Steelcase Nurture team, from the way they approach their work to the “why?” it is important. Part of this tour included a very enthusiastic look at the products, given to us by Libby Ferin, Director Experience Marketing & Communications.

The thing that I noticed both in Libby’s comments and even in things like which books were selected to be placed in the showroom was an integrated belief in the importance of the role of the patient and family in care. She referred to a prototype hospital room not as a patient room, but as a patient/partner/family room.

In the room itself, note that the patient and family have a view into the electronic health record that is tied to the role of the person in the room (based on a sensor located at the room’s entrance). Every room has spaces for families to engage, in recognition of the fact that “visiting hours” are long-ago concept. The lights over the sink that blink until new visitors wash their hands are a great way for patients and families to be involved in infection control efforts in a soothing way….

Clearly, we were touring a product showroom (and I don’t endorse any third party products or services on this blog, see my about page about conflict interest and independence of financial ties), the essence of my impression is that an organization in an industry outside of health care can be a model for health care organizations in reinforcing the best ways to work with patients and families.

The look at the products was tied to a look at the process, which includes two terms I haven’t heard before, but celebrate: “Evidence Based Design,” and “Participatory Design.” We know there is evidence-based medicine. Now that participatory medicine is becoming a part of health care, it has an analog in another industry, this is good.

As an aside, I really liked the way the Nurture design team presented their process, by printing out the slides and taping them to a board. It’s simple, sets expectations for the audience, and forces a focus on images and feelings rather than words:

What are some specific content things I took away from this meeting?

  1. Where is design in the HIT stimulus package? Much like a municipality might have an “arts tax” on public works, I think that a portion of the resource going to place technology in health care should be devoted to supporting the richest environment for its use. This is everything from placement, to lighting, presence or absence of sound (Kristen Juel from Kaiser Permanente hosted a fascinating conversation about the role of music in health care settings).
  2. What is the role of innovation/design in the success or failure of personal health care? Amy Tenderich has been a leader in thinking about this for diabetes. What about high blood pressure, an activity that is highly recommended but poorly practiced? We saw a great case study of how the “fridge pack” for soft drinks dramatically increased the consumption of aluminum. What’s the “fridge pack” for home blood pressure monitoring?

And on the deeper question…innovation in health care and among clinician groups: I think there’s a role for both learning about the techniques of innovation and applying them to solve problems in health care, and patients and those who care for them (physicians, nurses, allied health) should be involved, especially those closest to the patient(s) and their families.

I don’t know of organizations outside the Innovation Learning Network supporting exploration of this question and some of the answers, so from this perspective it was a great experience. If any of the readers of this blog know of other organizations stimulating these discussions, please feel free to post that information in the comments, or your answer(s) to the question about how and why medical groups or clinicians should integrate innovation learning and skills into their work.

Photo Friday: Not a Workstation, a Walkstation

May 8th, 2009 | Popularity: 20%
1 comment

Ted and Margaret on FitWork Workstations

This week’s photograph was taken by Kristen Juel using her mobile device (hence the blurriness – original photo posted at Twitpic here) of myself and Margaret Laws, Director of Innovations for the Underserved Program for The California Healthcare Foundation, during one of the open space networking sessions at the Innovation Learning Network in person meeting in Grand Rapids, Michigan.

The topic of this session of open space networking was, of course, the walking meeting, which is a simple innovation that can transform everything from business conversations to clinical care (imagine a medical center equipped with a sound insulated walking track in its perimeter, to allow clinicians and patients to walk and talk about their daily lives).

These workstations, called Fitwork, are manufactured by Steelcase and allow users to walk at up to 2 miles per hour, while working on their computers or talking on the phone.

There are so few reasons not to have walking meetings, why not try one this week? I’ve compiled some of the evidence behind their benefits along with a handy guide to getting started.

Gathering with the Innovation Learning Network in Grand Rapids

May 6th, 2009 | Popularity: 19%
0 comments | Leave a reply

I am here in Grand Rapids Michigan, for the in person meeting of the Innovation Learning Network , which:

The Innovation Learning Network (ILN) brings together the most innovative healthcare organizations in the country to share the joys and pains of innovation. Its purpose is to foster discussion on the methods and application of innovation/diffusion, ignite the transfer of ideas, and provide opportunities for inter-organizational collaboration.

The list of organizational members is on the home page. This meeting is being held at / hosted by Steelcase , the office furniture manufacturer. I was excited to come to this one (and I was not disappointed), because I have heard about Steelcase’s work in innovation, and when I went to go visit the Institute for Family Health in October, 2007 Neil Calman, MD, told me then about the Nurture product family. I’ve been intrigued since then….

The team managing the ILN have been very open and receptive to new communication modalities (of course), so have encouraged live tweeting of the event, which you can access here. As was done at the Health 2.0 Conference, they projected the live tweets in the room on the wall. This feature will probably be embedded in a lot of conferences to come.

On day 1, we went through a gallery of innovations prepared by members of the network, and got a brief introduction to the Nurture line and the philosophy behind it.

I was especially delighted to sit in the prototype “consultation room,” complete with electronic health record mockup, that demonstrates that through research, the Nurture team, in collaboration with the Mayo Clinic, found that optimal placement was with the patient and the physician sitting next to each other. The philosophy is reflected throughout other parts of the line (discussion tomorrow).

The other interesting thing that has been done is a randomized control trial, comparing ambulatory consultations performed in a room like this (pictured below), to a traditionally situated room, with a corner desk and computer in between doctor and patient. Finally, evidence based design in the era of Health Information Technology…..

Demonstrating “today” at The Sidney R. Garfield Health Care Innovation Center

December 2nd, 2008 | Popularity: 33%
1 comment

I am here in Oakland, California, and having completed my first presentation about Kaiser Permanente’s work in health care information technology, I have now done my first live demonstration of Kaiser Permanente’s work, at the Sidney R. Garfield Health Care Innovation Center, in Oakland, California.

Just as with the presentation, I was a little nervous about the demonstration. Unlike the previous health information technology environment I was a part of, this one is between 10 and 100 times as vast, and I wanted to respect the work of the experts who were involved in making it happen.

And, the experts have done great work – I looked at a specific aspect of Kaiser Permanente’s care, highlighted in this television advertisement, that has resulted in a 30% lower death rate from cardiovascular disease among Kaiser Permanente members relative to other Californians. Kaiser Permanente, by the way, has funded expansion of this program to patients outside of Kaiser Permanente through its Community Benefit work.

The demonstration was attended by other Kaiser Permanente experts and members of the national media, to see “today” and “tomorrow.” And there’s lots of tomorrow happening here, because the reality is that there are still very few organizations that are at this maturity level of electronic health record use.

I’m including some photographs below, and I am supported in sharing them here, just as the innovation will be shared. There’s a fully simulated hospital ward, ambulatory medical center, and even a patient’s home (because that’s where the hub of good health should be). A lot of what is being developed here will find its way to patient care inside of, and outside of Kaiser Permanente. A lot of it already has. From reading Sidney Garfield’s writings, this is by design. Enjoy and feel free to let me/us know what you think.

Photo Friday: Startup Culture in DC (Tech Cocktail DC)

October 3rd, 2008 | Popularity: 21%
1 comment

Ted Jen Doug Tech Cocktail DC

This week’s photograph comes from Tech Cocktail DC 3, which happened on October 2, 2008. Tech Cocktail is a community building startup whose mission is “to amplify the technology signal in under served markets and have fun doing it.” Pictured are myself, Jen McCabe Gorman and Doug Elliott, Director of Sales & Marketing for Mingle360, one of the technology companies featured at the event.

With diet soda in hand, I got a small taste of the energy in our nation’s capital for innovation. It’s definitely here, and these environments are great places for health care professionals to learn about what’s next in technology. I think it’s also not a bad thing for technology startups to know that health care is interested in applying talent in the care of patients as well. As usual I see lots of application in clinical medicine in places like this. With thanks to Twitter for the tip off to the community building, as a community builder itself. More photos below.

Speaking of innovation in health care, Kaiser Permanente is working to create social networking spaces within the organization, which is terrific. As a result, I am now reposting and creating original content for a blog I have set up there, which I’m calling “Ted Eytan, MD, InsideKP.” For that audience’s benefit, Photo Friday is designed to visually highlight the diversity of the communities we serve, once a week, to keep the focus on my/our purpose to help people achieve their life goals through optimal health.

In Front of the Counter with the Innovation Learning Network

September 25th, 2008 | Popularity: 24%
0 comments | Leave a reply

One of the (many) groups I am excited to participate with in my new role is the Innovation Learning Network , which “brings together the most innovative healthcare organizations in the country to share the joys and pains of innovation.” Kaiser Permanente is a member, of course, as are many other leading edge American health organizations.

In learning about the Network, I spoke with Scott Heisler, RN, MBA, who works with the Kaiser Permanente Innovation Consultancy. He walked me through the innovation approach used by the consultancy (which by coincidence I read and blogged about right here), and then presented a concept that really interested me – the “in front of the counter / behind the counter” sensation that we sometimes have in health care.

I did a little looking on line and found this on McDonald’s Corporate Responsibility blog:

I couldn’t help but think about the challenges that all of our businesses have – regardless of our industry or size of operations – making the connection with our customers on the environmental improvements we have, and continue, to make. So much of our innovation happens “behind the counter”, so it’s almost invisible to our customers if we don’t proactively communicate it.

I think this is a useful way to think about things, especially when we talk about involving patients. Are we thinking about the front-counter experience in everything we do? Are there times when we inappropriately ask people who are part of the care team (nurses, allied health, other physicians, patients and their families) to be in front of the counter when they should be assisting behind the counter? Or should we change the front of the counter experience in such a way that people don’t have to come behind the counter to support a safe, affordable, high quality care experience?

I then remembered what’s happening with New York City restaurants, and one in particular: when more information was provided to consumers, Le Pain Quotidien learned that this was better business for all of their stores (including Washington, DC) and adjusted things behind the counter to support it.

It’s interesting to think about how working from the front of the counter can create improvement…..Either way, I’m looking forward to following the work of the ILN, and encourage readers from innovative organizations to think about doing the same.

Sidney Garfield, MD: Rationally Organized Medicine

September 11th, 2008 | Popularity: 20%
0 comments | Leave a reply

I am going through new employee orientation here in Oakland, California, and was taken by these images on a conference room wall. They are of Sidney Garfield, MD, one of the founders of Kaiser Permanente, and a selection of his drawings.

As I wrote earlier on this blog, I think it’s really important to learn about where we came from as a profession so we can best think about where we are going. I wrote about the writings of Sidney Garfield in another post (you can see that, and a link to his Scientific American article here). Dr. Garfield was a medical leader who was focused on happy patients and happy doctors, unencumbered by financing mechanisms in his thinking.

I thought the concept of “Rationally Organized Medicine” was really interesting; could it be connected to a concept of “Results Only Medicine” (as determined by patients) in 2008? See what you think.

AHRQ Requests Input to Develop an Innovations Research Portfolio

September 9th, 2008 | Popularity: 15%
0 comments | Leave a reply

This is a nice, not too effort-intensive way, to provide ideas to AHRQ for developing innovations research. What are areas of patient-centeredness, patient-leadership, that AHRQ could investigate to support an effective, efficient health care system? Let them know!

NOT-HS-08-013: Request for Information (RFI): AHRQ Requests Input to Develop an Innovations Research Portfolio

Clay Shirky at Web 2.0 Expo SF 2008 – "where do you find the time?"

August 25th, 2008 | Popularity: 13%
0 comments | Leave a reply

People Don’t Hate Change, They Hate How You’re Trying to Change Them

July 21st, 2008 | Popularity: 17%
1 comment

I was speaking with Jane Sarasohn-Kahn today about some work she is doing for the California Healthcare Foundation and she asked me the question, “Do you think physicians would pay for their own continuing medical education (rather than being funded through industry support)?”

I immediately thought of this manifesto that I just read, whose conclusions I couldn’t agree more with, when I said, “yes we would.”

ChangeThis :: People Don’t Hate Change, They Hate How You’re Trying to Change Them

If you believe that people hate change and that it is your job to change them, they will hate it. If you believe that people thrive on change and that your job is to unleash it, you will tap into a limited source of ingenuity, energy and drive that will allow you to consistently take your ideas into big results.

This is exactly the theme we uncovered the Patient Centered Health Information Technology initiative, and what I have described many times on this blog and on the DailyKaizen blog (see: Let it Burn; a Wildfire of Respect), when I said, “in every part of every company there’s a monstrous capacity for creativity waiting to be unleashed.”

I sometimes hear about people in healthcare being “change averse.” I don’t think they are at all.

As we move toward Health 2.0, we have plenty of capacity to do things differently; nothing is static if it means doing things better for our patients. It’s what I see, again and again.

Piracy | Look for the silver lining | Economist.com

July 20th, 2008 | Popularity: 13%
0 comments | Leave a reply
  • Piracy | Look for the silver lining | Economist.com – I am not drawn to the idea of piracy as a source of innovation as much as the idea that providing knowledge to your competitors spurs innovation. If there's an approach to helping patients be healthy, I want to share it, and vice versa.

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

April 16th, 2008 | Popularity: 55%
0 comments | Leave a reply

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

Photo: Bear Added Riches in Trust for Mankind

April 12th, 2008 | Popularity: 48%
2 comments

I walked past this sign, welcoming people to Pomona College, in Claremont, California. As our profession thinks about broadening consumer health informatics to help more people (from diverse backgrounds and parts of our society), we should remember to share the added riches of our learning, experience, and ideas for improving health care in trust for mankind. More innovation happens when more is shared, not less. This includes what we did well with, and what mistakes we made.

Pomona College Pomona College Pomona College

Steve Jobs and Leadership Philosophy; Health Plans and AMA less EHR supportive?; Two Health2.0 Services

March 10th, 2008 | Popularity: 63%
0 comments | Leave a reply

March 4th through March 6th:

Health 2.0: Interesting new EHR Platform, Microsoft and Google, Wrapup

March 5th, 2008 | Popularity: 42%
2 comments

Health 2.0 is now over, and it was a great experience. I am not the only person in the room that remarked that they felt less innovative than ever in this room of innovators. The patient experience was front and center. I / we need to see that, often.

The post-lunch surprise was a demo of Microsoft’s HealthVault, accompanied by a post-demo comparison of the HealthVault and Google Health product by Missy Krasner. Overall a great discussion. I’m happy that more, rather than less, is happening here.

From my perspective I thought a big splash was made by the new EHR platform that Jay Parkinson, MD, demonstrated, manufactured by Myca. It has a compelling patient portal aspect as well. Interesting to see what happens when people start from scratch and build things the way they want to use them.

My comments in the Seattle-PI Health Blog; Characterizing Respect for People in a LEAN organization; A Cooking Light Best City (Washington)

February 23rd, 2008 | Popularity: 27%
0 comments | Leave a reply

February 20th through February 22nd:

79 Day DCVersary, a Hug-In, the Dupont Circle neighborhood

December 13th, 2007 | Popularity: 44%
1 comment

I missed the 60 Day mark due to travel, so this is the 79 day DCVersary. Still a green light, and greater appreciation for this environment by the day. In what other community do people respond to intolerance by staging a hug-in?

There’s a few stray links below about a recent report on RHIOs, and new “innovation” in ISPs accessing the code within Web pages for their customers – a new first.

Links for December 11th through December 12th:

Changing Physician Education; Social Media in the Workplace, Questions about HPV Vaccine

November 20th, 2007 | Popularity: 38%
0 comments | Leave a reply

November 14th through November 17th: