PCHIT Advisory Group

The last few days has brought work that is PCHIT-the Initiative centric, which is good. I always say that if there’s something I can do better, I want to know about it. Our Advisory Group meeting happened on schedule yesterday. The process of the preparation and hosting of the discussion will be very useful moving forward. Josh and I will summarize things here in the next few days. In the meantime, here’s a photo of this very accomplished group, at the Center for Information Therapy.

From left to right: Joshua Seidman, Ph.D., Deven McGraw, Susannah Fox, Veenu Aulakh, Ted Eytan, MD, Rachel Block, Charles Milligan, Jr., and Michael Barr, MD, MBA, FACP. Not pictured: Patricia Flatley Brennan, RN, PhD

You can read biographies of Advisory Group members by clicking on this link.

PCHIT Advisory Group

2 Photos: Ted, Rachel, and Barracks Row

A lot of reflection and housekeeping happened this week, in prep for another journey next week to visit with another great community, Boston, Massachusetts. I was honored to attend The Health Affairs Silver Anniversary Gala as a representative of Group Health Cooperative and Kaiser Permanente, which was a presenting sponsor.

The first image is of myself and Rachel Block, from the United Hospital Fund of New York City. Rachel is one of the funders and mentors that I am working with on the PCHIT project. We had a very productive day together at our first advisory group meeting.

Ted and Rachel

One more photo this week, of Barracks Row, in the Capitol Hill neighborhood. I was introduced to this neighborhood officially by Lygeia Ricciardi who runs the Project HealthDesign Blog, in addition to a portfolio of work promoting consumer empowerment. There is a large community of talented professionals here who are both working to support a patient/person-centered health system, and willing to introduce diverse parts of this community to new arrivals. I highly recommend both the neighborhood, and the blog.

Barracks Row

The new kp.org

Part of the support for PCHIT comes from Kaiser Permanente, which operates the kp.org portal for its patients. Part of what we’ll do is to demonstrate the work that organizations are doing alongside kp.org, which has 1,558,651 signed up for secure features, as of second quarter, 2007. I think that makes this one of the largest, if not the largest in the world.

Kaiser Permanente has posted a flash video of the new kp.org for external audiences which will include “My Health Manager.” Take a look – what do you think?

I hope to be shadowing in a Kaiser Permanente facility soon to observe how physicians and staff leverage kp.org in practice. The mid-Atlantic Region is pioneering online booking of medical appointments right now.

First PCHIT Advisory Committee Meeting

Josh and I are gearing up for tomorrow’s first PCHIT Advisory Group meeting, at the Center for Information Therapy headquarters in Bethesda, Maryland. Why an advisory group? We would like to add additional perspectives and knowledge from other communities/projects to this work, among other things. We plan to post materials from the meeting here, so everyone can be informed about the progress we are making.

Speaking of progress, one of the things I am doing is integrating practices from the Toyota Management System into this meeting as well as the entire project. For tomorrow, this means presenting the work as a PDCA cycle, and using A3 documents, in paper form, to go over things, as opposed to a slide deck.

We’re excited to host this distinguished group and think things will go well, which means we’ll learn how we can improve things for the next communities we visit.

Next Stop: Boston

Things are busy around here. We are hosting our first Advisory Group meeting this week, and then heading to community #2, Boston, Massachusetts.

While there, we will be observing practices at Harvard Vanguard Medical Associates, who operate MyHealth Online, Partners Healthcare, who operate Patient Gateway, and East Boston Neighborhood Health Center.

How do we set these up and what do we do? First, we establish contact with the appropriate leader in the organization who is willing to let Josh Seidman and/or myself observe the process of care. In the case of this community, we’ve really been helped by Joe Kimura, MD from Harvard Vanguard/Atrius Health, Jonathan Wald, MD from Partners Healthcare, and Frances Kuebler, MD, from East Boston Neighborhood Health Center. Even with an introduction from a leader in the organization, there is still some relationship building that needs to happen with busy clinicians, and I will typically do that on the spot. In the case of Harvard Vanguard, I have already met the clinicians who are allowing me to watch the process of care.

Speaking of naming names, Neil Calman, MD asked me a provocative question, about the naming of individuals I shadow (not the patients, their experience is always protected). I have always assumed in a public space like this that not everyone wants to be explicitly named. On the other hand, I haven’t minded being named in another person’s blog as long as the reference is accurate.

So, with this trip, I am going to ask the question about attribution to those who I work with, as a little informal poll.

To the readers of this blog – what do you think – is it useful to the story to hear specifics about the practitioners we work with? Thanks for the input.

Payers and Patient-Centered Primary Care; Google; Quality info in MA

PCHIT links for October 26th through October 27th:

Neil Calman, MD, now in the blogosphere

I was treated to the news that Dr. Neil Calman, President of CEO of the Institute for Family Health has launched his own blog, at http://neilcalman.blogspot.com/. Of course I’m excited by this as I got to meet Neil and his care system very recently and will look forward to being updated about things as they happen with Neil and IFH. When I see Neil, instead of asking, “what’s happening, Neil?” maybe I’ll be asking, “how’s that thing happening, Neil?”

I have noticed in some of my own professional interactions that the conversations start more deeply, more quickly, when I am having them with someone who has been following a blog of mine. I have to remember what I write so I don’t tell the same story. My antidote for this is to appeal to others to have their own blogs, so they can experience the same embarrassment.

I think this is a great way to stay connected to other leaders, and hopefully we’ll have Neil write a few guest posts about the work IFH is doing to support patient centered health information technology.

Hansei and an Evolutionary Leap (x 2)

Hansei is a Japanese term for self-reflection. It’s a concept that’s used in LEAN, and I think useful in life.

For my main project, PCHIT, I am doing the official Hansei, near the 30 day mark, as my advisory committee gets ready to convene in Bethesda this week. On the general topic of this experience, I’m doing the same, informally, at the 30 day DCversary mark, right here.

Overall? Green light. It has been great to explore an entire community (and to some extent a nation) of organizations and the talented individuals in them. This is something that there wasn’t time/resource to do with a focus on a single organization previously.

Step counts on the pedometer here are about 30-40% higher each day here, which is also great. A long walk here doesn’t seem so long because of the density of stimulating things going on. The vibrancy of this experience is only heightened by the unusually sunny, rainless weather. These things make a difference.

The Evolutionary Leap comes from the fact that this is now coming to you from Mac OS X Leopard. The x2 is that this blog system is also now upgraded to the most recent version. Both experiences tell important lessons about how good I.T. can be. The Leopard upgrade – flawless, with many user-centric features that make productivity faster and more enjoyable. The blog upgrade – also flawless, but with a little more care and feeding. The open source nature of the blogging platform means that everything needed is in reach, but “activation and empowerment” are needed to make informed decisions about which parts to upgrade and the smoothest path. Leopard is a closed ecosystem, but one that is carefully managed, with great results. And I say that as someone who really isn’t a technophile. More on that later…

Photo Friday: The Hirshhorn; 30 day DCversary

This week’s photo is of people waiting at the Hirshhorn Museum and Sculpture Garden. It came just before a viewing of a documentary about the world of art and video games called 8 Bit. I have to admit I was both a bit nostalgic and concerned at the same time when I saw images of SimCity 2000. I have an unfortunate belief that this is a state of the art video game, but apparently my information is only as current as 1993. My records are now updated…

It’s my 30 day DCversary today. I’ll post reflections on my first month on Monday. By then I should be Leopardized.


Patient-Physician E-mail: An Opportunity to Transform Pediatric Health Care Delivery

Patient-Physician E-mail: An Opportunity to Transform Pediatric Health Care Delivery — Rosen and Kwoh 120 (4): 701 — Pediatrics

Josh Seidman alerted me to this recently published study of the use of patient-physician e-mail in a smaller pediatric rheumatology practice. The study shows that the state of the art for many practices like this is still unencrypted e-mail as was used in this case. At the same time, the authors did a nice job quantifying time spent communicating this way as well as the impact on patient satisfaction. Of significance, they found that e-mail responses took physicians 57% less time on average to complete.

The article adds to the body of knowledge that this is a good thing to do. Of course, I might ask if in the future we should quantify the time savings to patients in addition to / instead of to physicians. The other curiosity I had after reading the article was the statement repeated multiple times throughout that “pediatricians are leaders when it comes to using patient-physician e-mail.” I didn’t see any data to support this. Maybe this is a bit of cheerleading to enhance adoption in the pediatrician community? At this point in our work, I can imagine that it is important to describe differences in various specialties’ use of patient centered health information technology, but not sure of the importance of singling out any specific specialty as the “leader.” Open to any comments to the contrary….