OHA Health Achieve 2007 – thoughts from day 2

by hans on 2007/11/07

Wow. What an exciting day. Yesterday on day 1, I heard Colin Powell speak about leadership at the opening address. Today, I stayed for the entire day and attended both the morning and afternoon sessions.

Morning Session – “Innovation and all that Jazz” by Wynton Marsalis
Originally, I wasn’t sure if I was going to attend this session, but I am sure glad that I did. Wanting to find a quiet space, I arrived early at the hall and found a seat. Much to my surprise, I saw instruments on the stage – Wynton Marsalis was going to perform! Wow.

Wynton Marsalis used his experience as a jazz musician to talk about innovation. He took the audience through the history of jazz and highlighted different types of innovators. What was amazing was that after each explanation and discussion, he and his band would give live musical demonstrations of the concepts he described. I can’t begin to detail the performances, but here’s a quick summary of Marsalis’s session.

There are several types of innovators, each with different paths and skills.

  1. the Promethean innovator – This type of innovator introduces a totally new way of doing things, seemingly original, unique, and fully formed straight from the mind. Marsalis highlighted Buddy Bolden as the originator of jazz – a person who combined the church and secular styles of music found in New Orleans. This new combination of seemingly opposite forms unleashed a new freedom.
  2. the Prodigious innovator – This type of innovator is what we would call a “prodigy” – someone who masters a discipline at very young ages, drawing both admiration and resentment at the talent. Because they are so talented, these people quickly learn the limitations of their form and look to transform their art with a deeper sense of what is possible. His examples was of Beethoven moving from the classical forms of Haydn to inspire the Romantic movement.
  3. Those who completely remake a style in their own image – These people tend to go against tradition and convention, often getting ostracized and/or persecuted because the establishment hates to be told what to do, or that it is wrong. Their innovation is in completely remaking or reinterpreting a style in their own image. Thelonius Monk is an example.
  4. Group innovators – Marsalis described how sometimes, groups of people come together either through competition or through cooperation and collaboration to create something new and amazing. He pointed to Dizzy Gillespie and his contemporaries for developing the Bebop style as something, exciting, challenging, and demanding.
  5. unique innovators/”aliens” – These types of innovators are so uniquely different, it’s as if they are from another planet or that their DNA is written completely differently. He pointed to Berlioz, Joan of Ark, and Walt Whitman as examples. They just do brilliant things and we can’t really understand them, except to appreciate them.
  6. average or “below” talent innovators – These are the rarest in any field. Through years of study, sacrifice, edurance, and persistance these people work to innovate at their craft. Marsalis commented how the “search itself reveals the innovation” and illustrated how John Coltrane was, at first, considered a below average musician.

As mentioned, after each “section”, Marsalis and his quintet (piano, sax/clarinet, drums, and double bass – my apologies, but I didn’t catch their names) played a for a few minutes. All I can say is wow. That was awesome!

Marsalis ended by explaining that jazz teaches us all that we have something to contribute and create. Jazz helps us unlock the creativity in others while working in concert together. He talked about the give and take relationship required for all of the band members to succeed, and yet have opportunities to express one’s creativity and personality.

One final note about this session – it felt like a jazz concert and I could seem heads bopping, feet tapping, and bodies moving. Marsalis is a very engaging, dynamic, and funny speaker. I never realized how accomplished he was outside of his jazz playing (read more about him at wikipedia, official website). I’d have to say that this was one of the best sessions that I have attended. Here’s a link to Wynton Marsalis’s website with a brief blurb and set-list.
Afternoon Session – Health Information Technology
Every year, I like attending the ehealth/health information technology sessions as a way of getting a pulse for some of the developments happening in Ontario. It’s also a great networking opportunity. This year’s session was a bit different in that there weren’t competing sessions as the groups decided to work together. The afternoon session actually had two speakers and a panel discussion.

SPEAKER #1: Dr. Christy Valentine – “Health records recovery: Lessons learned from New Orleans”

Dr. Valentine described her experiences as a physician in New Orleans during and after the flooding caused by Hurricanes Katrina and Rita. She described some of the challenges of rebuilding the health system there, with hospitals being closed forever and many others in danger of not surviving. One of the greatest challenges after the flooding was to reproduce medical records because they were almost all paper records.

Dr. Valentine’s main lessons/suggestions were:

  1. Have and improve emergency plans to prepare for disasters
  2. Prepare and improve emergency communication protocols
  3. Develop uniform triage standards across multiple institutions
  4. Stock basic medical supplies

She also pointed out that patients should also develop their own emergency plans for their family, maintain and keep copies of immunication records and other health documents, and have a water proof disaster kit.

I was a bit surprised to hear Dr. Valentine’s message because her information seemed a bit … dated. Maybe we here in Canada have been fortunate to not suffer through a major natural disaster, but her lessons were things that were discussed at least 5–6 years ago. What I found interesting was that in New Orleans, and in many parts of Louisiana, electronic systems were being adopted very rapidly and because all the paper records were lost, they were essentially starting from scratch without having to worry about legacy systems, inputting old data, or digitizing forms. There also seems to be considerable interest by patients because of the difficulties post-Katrina. As noted, the US is undergoing an ambitious program to have a national EHR system by the year 2015 which was announced in 2005 by President Bush during a state of the union address. I got the sense that Ontario and possibly Canada is not as far behind as people would suggest.

SPEAKER #2: Michael Decter – “Connecting the public to their health care: How consumers demand for and use of information is changing industries and what it means for health care”

Basically, Michael Decter talked about his book, Navigating Canada’s health care: The user guide to getting the care you need. He described how patients need to learn how to navigate through health services, much like how a tourist would when visiting a foreign country. Having a user guide isn’t a bad thing – it just recognizes the complexity and history of the health system in Canada.

Here are some highlights of his talk:

  • Health care (today) is not an informed journey. Patients need to take responsibility for navigating through the system.
  • Most modernization efforts are focused on health providers, with little emphasis on consumer technologies.
  • The health care consumer has changed. Life expectancy over the past 40 years has inreased more than in the past 2000 years. We need to change the perception of patients, as the patient is no longer “dumb”.
  • We have an acute care system that is trying to treat complex chronic conditions in an episodic fashion.
  • Patients want their health information in one place. EHRs and other systems aren’t good enough if they don’t provide the necessary information. Decter gave an example of his company’s back-office system for managing client financial accounts. While worth hundreds of millions of dollars, he uses Yahoo!Finance, a free service, because it provides more valuable information for him to use when trying to manage client accounts. Will industry titans like Microsoft or Google be able to meet this need?
  • Patients are self-managing themselves. Health professionals need to take on the role of a coach, as the average patients sees a physician for about 60 minutes in a year (based on Kaiser Permanente data). Patients don’t want their physicians to be coaches, but other health professionals to fill this role because they can spend the time with them. We need multidisciplinary teams that can access patient information to provide the best care. Patients need access to their own data.
  • Many people don’t understand the benefits available to them, either the appropriate tax deductions or those offered via employee benefit programs. Someone needs to promote and educate people about these missed opportunities.
  • Practice makes perfect. Volume of services makes a difference in outcome and quality of care. Patients need to learn to ask questions, while the organizations need to become more transparent. In a interesting twist, Decter argued that while organizational performance data should be provided, individual practitioner data shouldn’t be made public. He qualified that by suggesting that the professional colleges and organizations need to do better jobs of over-seeing professionals.

Overall, Decter’s presentation was interesting and informative. He touched on a number of practical issues that consumers need to address because of a lack of a true “system”. Based on his talk, I think I’m definitely going to check out his book.

After Michael Decter’s talk, there was a panel discussion about the topic of the changing role of consumers in health care. Each panel member was asked to present a short (<5 minute) presentation on his/her area of expertise. Here are the short summaries of each panel member:

  1. Alex Jadad (Chief Innovator & Founder of the Centre for Global eHealth Innovation): His main point was that the public will not wait for the health care system. He presented data about how health care is losing mind-share to new sites on the web because of control issues. If we don’t move faster, others will come to fill the void.
  2. Kevin Leonard (Professor, University of Toronto): Kevin talked about some of his experiences as a person living with a chronic condition and highlighted the patient’s new role. Patients need to be involved in the design of systems. While accounting for a small portion of all people, the chronically ill and newly diagnosed account for almost 90% of all health traffic.
  3. Cathy Szabo (Executive Directo, Central CCAC): Cathy talked about some interesting initiatives regarding the sharing of information by hospitals and community organizations. She also shared some of her personal accounts of working in the community. Our system needs to meet the needs of elderly people who don’t want to use the Internet.
  4. Diane Beattie (VP/CIO, London Health Sciences Centre): Diane focused on how to make information more fluid across the system. She mentioned a European study that found that if you change your processes before implementing technology, you can expect cost savings of about 20–30%. If you introduce technology first, and then try to change the processes, costs tend to go up 5–10%. Her main thrust was about supporting health professionals in using information technologies.
  5. Donna Hammill-Chalk (Patient Participant, Sunnybrook Health Sciences Centre): Donna shared her experience as a patient newly diagnosed with cancer and how she struggled to manage her care in a system that isn’t very responsive. Based on her experience, she thinks that patients need access to their information, better continuity of care, and improved timeliness of the system – why do we need to wait days or weeks for a lab result when it can be shared in seconds?

After each panel member presented, they fielded some questions from the audience. One of the final concluding thoughts that seemed to come up over and over again was the need to collaborate rather than compete with one other and that “one size doesn’t fit all”. A while back, Holly Witteman shared her thoughts on this topic during the eHealth 2005 conference. Interesting that it would come up repeatedly.


In all, day 2 was a very interesting day. I enjoyed the Wynton Marsalis session immensely as that was the first time I’ve ever experienced him perform live. The afternoon session on health information technology was lively and informative. I found it interesting that there was such an emphasis on the consumer/patient given that the convention is hosted and operated by the hospital community. I suppose we’ll see if this is all just talk. But, based on what I know of some of the speakers and of the leaders I’ve met in the health care system, I think they are all genuinely working to try and make the system better. Sometimes, as an individual, it’s not possible. Maybe this idea of collaboration will be the key that unlocks the solution to this problem.

Tomorrow’s closing session will highlight Queen Noor. I’m looking forward to what she might have to say. I’m also interested to hear George Smitherman, the re-elected Minister of Health and Long-term Care speak. I still can remember his first address at the OHA convention in 2003 as a newly elected and appointed Minister. He was quite stand-offish then. In the past few years, he seems to have mellowed out and become far more collaborative. Based on some of the comments I’ve heard from the crowd, people seem to be pleased with his efforts – he’s passionate, has a vision for what needs to be done, tries to partner as best as he can, and is results oriented.

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