The anti-creativity checklist March 18, 2010
Posted by Hans in : resources , 1 comment so farA very interesting post from Youngme Moon at the HBR blog titled “the anti-creativity checklist“. The list is one that is “guaranteed to stifle imagination, innovation, and out-of-box thinking … a checklist designed specifically for people who want nothing to do with disruptive change”. I like the approach to looking at the opposite – too often we look at the “things you must do to achieve X” and forget to look at the barriers or “things we shouldn’t do”.
The list is presented in video format with some additional comments that you are likely to hear. However, if you’re impatient and want to see the list immediately, I’ve written them down to see.
- Play it safe
- Know your limitations
- Remind yourself – it’s just a job
- Be skeptical – show you’re the smartest person in the room
- Demand to see the data
- Respect history – always give the past the benefit of the doubt
- Stop the madness before it gets started – crush early stage ideas with your business savvy
- Use experience as a weapon – “been there, done that”
- Keep your eyes closed (and mind too)
- Assume there is no problem
- Underestimate your customers
- Be a mentor – give sound advice to people who work for you
- Be suspicious of the “creatives” in your organization
- When all else fails, act like a grown-up
Unfortunately, I’ve experienced too many of these in my short work history. I think the biggest threat to creativity is #5 “demand the data”.
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What’s in a name? Checking for username availability in social media sites via namechk March 18, 2010
Posted by Hans in : resources , add a commentGiven the explosion in both social media and other types of sites require registration, the ability to get the same username across different types of services can be a very handy thing. When one considers the concept of a “web presence” and/or maintaining an online identity, getting a consistent username is quite important. Getting *your* username is almost as important as getting a web address/domain name.
I came across this handy site that automatically checks the availability of usernames/logins/handles for 145 social networking and bookmarking sites. The site is called namechk and it lists dozens of services that I haven’t even heard about.
Hopefully you will find the site useful.
Popularity: 2% [?]
Interactions with the health care system – a visit to the doctor’s office March 17, 2010
Posted by Hans in : analysis, opinion , add a commentI was doing some exercises Monday night and I tweaked my wrist during a moment when I lost my focus (and balance). After a night of discomfort and pain, I decided to try and see my doctor to rule out anything serious. I did some searching on the internet and found a good article titled “ulnar-sided wrist pain” which provided some very detailed information about the different types of pain in the wrist.
Scheduling the Appointment
I tried to schedule an appointment with my family doctor who is part of a group practice at the local medical centre. Unfortunately, when I tried calling in the morning, all of the lines were busy. It seems that every time I try to call the medical centre, the lines are always busy and that it’s practically impossible to schedule an appointment. Fortunately, the medical centre is only a few blocks away so I made the trek to make an appointment with the faint hope that they might be able to see me soon. No luck, but they could see me at 5pm later that day (Tuesday). Question – why does the receptionist have to ask what the problem is? Isn’t that something of a personal and private issue that should be discussed only with the patient and his health professional(s)?
Arriving and Waiting
Against my better judgement, I arrived at the medical centre 15 minutes early and checked in. There was the asking of for the health card and then I was asked to sit and wait. I ended-up waiting about 45 minutes before my name was called. I really didn’t notice the time passing as I brought some reading material (the December 2009 issue of Harvard Business Review spotlighting Innovation). I only thought about the time when I finished an article or when someone sitting next to me was called by the nurse.
Watching
Sitting in the waiting area, I tried to observe what was happening. Most of the patients looked bored as they sat and waited. The receptionists were busy chirping on their headsets and taking appointments or receiving newly arrived patients. I noted a clerk filing documents in the health records – she had a good sized stack of nearly 15 cm in height. Given how many pieces of documentation a medical centre receives, I can understand some of the frustration of trying to convert to an electronic system. There are just so many business processes that need to be synchronized in order to transition from paper given all of the potential inputs a patient’s record can have.
Seeing the Doctor
After walking into one of the exam rooms, the nurse asked me my name and then asked if I was seeing the doctor because of my wrist. She nodded and then asked me to take a seat: “the doctor will see you shortly” and then left the room, partially closing the door. After a few minutes, my family doctor walked in and asked me how I was doing. I told him that I hurt my wrist and wanted to make sure I didn’t do any serious harm. He asked me how I did it, examined my (right) wrist and compared it to the other, noting that there was some swelling and heat in the area. He poked and prodded different areas of my wrist and had me do some movements to test my range of motion. His diagnosis was that it was probably a sprain and indicated that wrist injuries are notoriously difficult to diagnose because of the complexity of the joint. He said there’s a small possibility of a fracture and ordered an x-ray. His final words were that if the pain persists after three weeks then I probably did something serious. Otherwise, I need to wait and see because the pain my “go away in a few days” or take weeks to months to heal.
Off to the Xray!
I walked over to the in-location x-ray service and presented the order to the clerk who was reading a book and looked very bored. After showing my health card, I was asked to wait for the technician. I heard a typewriter in the background as I waited. Once the technician called me, I was taken to the back and asked to deposit my things in a small cubicle before being led to the x-ray room. I had four shots taken of my wrist of different angles. Two of them had to be taken again as the film didn’t develop. As I waited for the x-rays to be processed, the developing machine looked like it was made in the 1970s. I also noticed a large plastic container with two different liquids. I forget the names of the two fluids, but they apparently need to be mixed. I got a chuckle from the hand-drawn line near the bottom with the word “refill”.
The technician gave me the processed x-rays and then I walked them back to my physician. He was with a patient so I waited just outside of the nurse’s station. The doctor walked out a minute later and we looked at the x-rays at the station. I know I couldn’t see any fractures, but I don’t really know how to spot a fracture. My doctor agreed that there was nothing wrong and sent me on my way as he moved to another exam room to see another patient.
Some Thoughts About My Visit
All in all, I was at the doctor’s office around 70 minutes and I interacted with my physician, a nurse, the receptionist, and the x-ray technicians for maybe 10 minutes total. As I examined how the very busy medical centre operated, I was trying to see if electronic solutions could make a significant impact on the practice. At first glance, I would have to say “no” as everything seems optimized to the physician’s needs – the nurse or office staff provide everything for the physician and patients are made to wait until the doctor is ready to see him/her.
From a cost perspective, would a computerized system (including electronic lab results and x-ray/diagnostic imaging) make much sense? I don’t know. The patient information is still stored via paper and much of it seems to be arriving from external sources. Notes are taken on paper and stored in the filing area which has very little physical cost compared with an electronic system which would have licensing fees, hardware, and electricity costs. Perhaps some of the clerks who do the filing could be let go or assigned different tasks. I can’t see much productivity gain in terms of having electronic imaging as the physician seems to be operating at near 100% utilization in terms of time.
What would make a big difference to a patient, however, would be an electronic scheduling system which could be accessed either by phone or on the Internet. But, I see this as being unlikely in the near future as the physician and the medical centre would lose power over its scheduling. Right now the receptionists act as the gate-keepers, restricting access to physicians.
I think the ‘last mile’ of physician offices is something that needs to be addressed as a great number of health care interactions take place there. Yet, I can understand why there is some reluctance to move toward electronic/computerized tools. The business case does not seem readily apparent. Some form of time-motion study using ethnographic methods and a formal business case should be conducted to take a look at this issue. Physicians are not the ones who are inconvenienced by paper based systems (as far as I can tell), especially if there is little information sharing outside of the physician’s office. I’m not blaming physicians at all – in fact, I think they get a bum rap sometimes because they are easy to pick on. Most of them are trying their best to navigate a system that is broken and doesn’t really support them to try and do more than operate their offices like a business. Physicians are people who have bills to pay and probably get frustrated too.
One final thought before I end this post (my wrist is starting to bother me now), with so many patients waiting to see the doctor, there has to be a way to make that time useful, either to the patient or some health care service. I was wondering if the medical centre could have a sign that indicated the approximate waiting time to be seen so that I could take a step outside or do something if the wait is 30 minutes or longer. Restaurants have the pager system that calls waiting patrons when their table becomes available. Couldn’t something similar be developed for physician offices? But why would the physicians care? They have people waiting regardless. Again, the challenge remains that patients are not at the centre of the system – the physicians are. Until we address this issue, then I can’t see meaningful changes occurring.
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Checklists – the latest fad to hit health care? March 16, 2010
Posted by Hans in : Uncategorized , add a commentI have a copy of Atul Gawande’s book “The Checklist Manifesto: How to Get Things Right
The main reason is because the mainstream media seems to be picking-up on this idea that checklists will improve care and outcomes and have started writing about it.
- ModernMedicine has an article titled “Medical checklists needed to improve care and outcomes“.
- Harvard Business Review has a podcast with Dr. Atul Gawande titled “Using checklists to prevent failure” and another blogger arguing that checklists will be a “transformative innovation” (How innovation can tame chaotic care).
- There’s also the New Yorker article by Gawande which had several of my colleagues talking about checklists in 2008 (The Checklist) in addition to the New York Times opinion piece “A lifesaving checklist“.
- In 2009, MSNBC reported “Simple checklist cuts surgical deaths in half“
- Dr. Gawande also appeared on the Daily Show
- CNN’s Dr. Sanjay Gupta did an interview with Dr. Peter Pronovost, author of Safe Patients Smart Hospitals
- Salan published a review of the Checklist manifesto
- It’s even been on Oprah (The power of a checklist)
Again, without having read the book, I can see how use of a checklist can help bring order to a complex environment. That’s always been the reason for use within the airplane cockpit. Some evidence on the impact of checklists is available from the AMA (Infection rates drop as Michigan hospitals turn to checklists) and the original NEJM article titled “An intervention to decrease catheter-related bloodstream infections in the ICU“
I’m hoping that checklists, even if they are a fad, do make a difference and improve care. If some of the needless complexity can be simplified with the knowledge codified (and thus more accessible), then this will be a great thing. Perhaps checklists will be a first step in making health care more open to disruption. Christensen’s theory points to the notion that codification of “expert knowledge” is a first step in making a process open to innovation and disruption. I’m just hoping that checklists can improve care.
Popularity: 3% [?]
Visualizing health care expenditures around the world March 15, 2010
Posted by Hans in : resources , add a commentCame across a great data visualization example from Visual Economics titled “health care costs around the world“. The data is presented in very interesting ways. What I found even more interesting was the lively debate and discussion in the comments. You should definitely check it out.
The rest of the site presents other examples of using graphics to present economic data. Economics isn’t quite my area of interest, but I think these types of efforts should be encouraged. I wonder what the impact on informed consent would be if risk and probability data were presented visually.
Popularity: 3% [?]
Tips for unleashing innovation March 15, 2010
Posted by Hans in : Uncategorized , add a commentCame across a very interesting article with a list of 10 tips to encourage and foster innovation. Here is the list of 10 practices:
- Let the learning lead
- Learn to see
- Design for today
- Think in pictures
- Capture intangible value
- Leverage the limitations
- Master creative tension
- Run the numbers
- Make kaizen mandatory
- Keep it lean
The author is Matthew E May, an innovation consultant, who has written a book titled In Pursuit of Elegance: Why the Best Ideas Have Something Missing . He also maintains a blog titled In pursuit of elegance.
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Making sense of revenues and profits in health care March 12, 2010
Posted by Hans in : opinion , add a commentI read this post on the Health Beat titled “Advice to hospitals in a downturn: Market the high-margin service” and I’m trying to come to grips with it.
Don’t get me wrong, the content itself was pretty much straight forward in that it provides advice on how to increase revenues. But, what I’m trying to get over is that the entire message just seems wrong to me. Perhaps being in Canada, I’m not used to speaking about increasing revenues within a health care context, at least not by hospitals. I recognize that there are business considerations that must be addressed, namely that health care is not free. Contrary to belief, health care in Canada isn’t free either. I understand the need to cover the costs of salaries, supplies, etc.
I’m going to think about this more and try to understand why the message just doesn’t sit well with me.
Popularity: 4% [?]
Dissertation defence broadcast live March 10, 2010
Posted by Hans in : news , add a commentI came across this blog post about a live-streamed dissertation defence. For those who don’t know, dissertation defences are usually closed-door meetings. At the PhD level, the candidate usually makes a presentation (usually about 20 minutes) summarizing his/her research to the voting members of the panel. Most schools require a minimum of three voting members which consist of the candidate’s thesis committee and some form of external review. The procedure is administered by a representative of the university who ensures that all of the rules are followed.
Not sure that I’ll have a chance to watch the event live, but if it’s possible, I will definitely check it out afterwards.
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Health care of the future? March 9, 2010
Posted by Hans in : opinion , add a commentThere was a very interesting series of posts at HBR Insight Center which focused on health care, specifically health care innovations. In the main post titled “Health Care of the Future“, the author presents a list of 10 innovations believed to have big impact.
- Checklists
- Behavioral Economics
- Patient Portals
- Payment Innovations
- Evidence-Based Decision Making
- Accountable Care Organizations
- Virtual Visits
- Regenerative Medicine
- Surgical Robots
- Genetic Medicine
I’ve thought about this list and I can’t really argue against any of the items listed here. I would, however, add point-of-care technologies (POCTs) and video games. In terms of video games, I’ve written about the potential to use gaming systems for health promotion (with Nintendo Wii as a great example) and also for other types of activities like teaching, interface development, simulation, and public engagement.
POCTs are poised to change the lab services market using a classic disruptive approach. Specialized knowledge is becoming more accessible as technologies advance. Individuals can now access diagnostic testing services in a matter of seconds at the point of care. I can see that treatments (based on an immediate diagnosis) can be developed to accompany the test. As an example, a blood sugar testing device could measure the sugar levels in your blood and then automatically inject the appropriate sugar/insulin based on pre-determined controls.
Do you see anything that is missed?
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The “y” in GE Healthymagination March 8, 2010
Posted by Hans in : opinion , add a commentDuring the 2010 Vancouver Olympics, I noticed a series of advertisements being played repeatedly promoting GE Healthymagination. The ads themselves were fairly well done and seemed to do a good job of conveying the message that GE is serious about health care and about being an innovation leader.
Each time I watched the ad, I kept asking myself – why? Why is GE doing this type of advertisement? All of the products GE was promoting seemed geared toward hospitals or other types of health care organizations – definitely not something that a patient could buy. It’s not like a patient can go into a hospital, doctor’s office, or other health care facility and ask if they are using GE products.
I did, however, manage to check-out the website and was quite surprised by the projects they have listed (descriptions are from the website verbatim – March 2010).
- Better Health Conversation: Healthymagination and WebMD are transforming your next check-up. Our Better Health Conversation helps people get more out of their next doctor’s visit.
- Morsel: Morsel is a mobile app that helps make healthier decisions a part of more people’s lives. Simple, daily tasks help people get healthier one step at a time. [Authors note: I downloaded the iPhone app and am testing it out]
- Sharing Healthy Ideas: Healthy ideas are catching on right now. See the most popular ideas being shared on our partner sites.
- Healthy How-Tos: Healthymagination and Howcast have partnered to create a series of engaging health based how-to videos.
- Visualizing Data: Healthymagination works with GE’s health economists and leading data designers to help make a wealth of information more relevant to more people.
- Health Innovation: Solving some of the world’s toughest health problems takes putting healthymagination to work. Our innovations are making it possible to create better health for more people.
- Better Health Study: GE conducted the Better Health Study with Cleveland Clinic and Ochsner Health Systems.
As for the “why”, here’s the description from their website:
Almost everyone wants to make healthier choices, but they don’t always know how. The amount of information available on wellness, nutrition and exercise is overwhelming, to say the least. Even when we do know how to improve our health, we often try to make sweeping changes or set goals that seem too daunting to reach.
Healthymagination is about becoming healthier, through the sharing of imaginative ideas and proven solutions. It goes beyond innovations in the fields of technology and medicine, celebrating the people behind these advancements. Seeking to build stronger relationships between patients and doctors, GE created healthymagination to gather, share and discuss healthy ideas.
Because healthymagination is about becoming healthier together, it takes the form of multiple projects that you can participate in, whether you’re looking to change your lifestyle or fine-tune your approach to health. Making healthy decisions should be easy…and fun.
Guess the advertisement didn’t really match-up to the work that Healthymagination is doing (in my opinion). One project that would be great for GE to pursue is studying how to make health care more accessible (from a service perspective) and more cost-effective.
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