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You Need To Pay Attention... Yes, YOU

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Recently, I had coffee with a personal friend whom I’ve known for several years. I like her personally and know she’s a good person; and we have some personal things in common. But this friend (who shall remain nameless) is also someone who has no interest whatsoever in politics or public policy, even though public policy developments have a strong influence on what she does for work (she’s highly successful in a non-health care field). In fact, she’s actively hostile to knowing about the world, except to the very limited extent that she must absolutely know certain things to do her job. She actually told me she doesn’t want to know anything about the world, and has no desire whatsoever to participate in our democracy.

Well, I have two critiques here. First, I think that, for anyone who is in an industry (which really means most industries, these days) in which rapid and dramatic public policy changes are taking place, should pay attention. That certainly applies to the health care industry right now. Comprehensive health care reform legislation, extensive reimbursement reform under Medicare, and all the activity and speculation around the federal stimulus (ARRA-HITECH) funds, are all not only in the mainstream media news these days, but also set to influence strongly how virtually everyone in health care works. So all these issue areas are really important.

Indeed, the entire operating environment around what CIOs and other IT executives, managers and leaders do day to day, is about to change, and perhaps quite dramatically. As fundamental an issue as who our patients will be, and under what conditions they’ll come into our hospitals, may be about to change. And certainly, what purchasers and payers are demanding of our provider organizations, is changing dramatically. I have long believed that CIOs and other IT executives and leaders need to become, and stay, aware of the broader industry winds constantly sweeping across our industry, to be truly effective. And if comprehensive health care insurance reform, and health care reimbursement reform, come to pass, even in a modified or compromise form (the legislative process is always complicated, of course), the results will be transformative for all of us.

And, I have to add, it is my view that we should all, as Americans, participate in the ongoing national discussion on changing the health care system. In fact, I think all of us in the health care industry have a special opportunity, to use our expertise, credentials, and experience, to help influence, and even shape, that debate. And isn’t that exciting? I think so. But regardless of whether one sees it as exciting or not, I do believe it is a special responsibility for all of us, or anyone who has special or useful knowledge, to participate in this important phase in the evolution of our industry. There is a wealth of perspectives and knowledge out there, and all points of view and types of information should contribute to the process.

And now, with legislative and policy developments set to accelerate in the next few months, we all need to pay attention, because how this all shakes out will affect every one of us—as health care professionals and as citizens.

Recently, I had coffee with a personal friend whom I’ve known for several years. I like her personally and know she’s a good person; and we have some

Comments

Mark,

I completely agree with you that we all have the responsibility to participate, and if we don't, we lose our right to complain about the outcome! I do, however, blame information overload for the fact that so many decide to retreat from the discussion between traditional media, online media, and now social media it's extremely difficult and time-consuming to take it all in, process it, and then form an intelligent, informed opinion. Especially when there are so many "experts" out there who claim that their opinion is the "right" one.

I've never been a CIO, but I can only imagine how tough it is right now to be in that position - trying to perform an already difficult, multi-tasking, multi-responsibility job, and simultaneously trying to sort through all the (often conflicting) information about the acronym-dripping legislative and policy developments heading their way. ARGH...

Exciting? Absolutely, but I can certainly sympathize with any CIO who yearns to turn off the computer and TV, ignore the stack of industry pubs in the mailbox, and pour a big scotch and head for the hammock!

G.

Anthony and Gwen, thank you both for your very insightful and helpful comments! Anthony, I absolutely agree, I think that all CIOs (and for that matter, all health care IT professionals) should learn to what extent the professional associations to which they belong are representing their own policy positions. There's a true opportunity here to be heard in Washington, and I know for a fact from my reporting for the October cover story in the magazine that Congressional staffers, for example, really do want to hear from health care professionals! Meanwhile, Gwen, I of course also totally empathize with CIOs who are overwhelmed. Sometimes, I definitely want to relax with a Scotch, myself! (or at least a lemonade -) :-) ) There definitely is information overload going on right now. That's one of the many, many reasons I love writing for this magazineI get to be a part of culling some of the information out there, and hopefully, presenting important information clearly to our audience, cutting through some of the haze and fog of buzz and overload. That's how I see it, anyway... In any case, thanks, both of you, for such helpful comments!

Joe Bormel,
Thanks for your terrific and thougthful comment! First of all, I totally agree that the daily avalanche of information and communications coming at all of is indeed often mind-numbing. I just went through 200 "new" e-mails yesterday, as my main e-mail cue was about to shut off because of overloadso I totally understand, and feel the same pain as everyone else!
I think ultimately, the only solution is to develop mental discipline and some self-imposed boundaries around what each of us pays attention to, based on what each of us thinks is truly importat. It will be totally an individual set of choices, of course. Some will choose not to pay attention to professional sports, some to tune out "Dancing With the Stars," some to exile from their radar screen some of the massive amount of local social information to have to manage (is my first-cousin-once-removed really getting a third divorce? and how much do I need to know about that situation?). My own bias, as revealed above, is that some basic topics we all need to know about, such as what's going on with our country and our democracy. But inevitably, the most successful people I know do consciously certain filters, in order to prevent becoming personally overwhelmed. In his 1989 book, "Information Anxiety," Richard Saul Wurman(who used to produce an interesting series of travel guides) noted that the amount of information contained in the daily New York Times was more than the average person in 17th-century England encountered in A LIFETIME. And of course, 1989 was a long time agonow we're facing daily blizzards of online and broadcast media information and input that dwarf what most people came across just 20 years ago! Wurman also gave various pieces of advice, in that book, on how to handle information overload.
Meanwhile, I think what I would say to that physician who approached you after your (obviously thoughtful) presentation is, "Well, Doctor, as busy as we all are, I think it's still important to choose certain subjects to pay attention to and keep up with, both professionally and personally, that we consider significant and worth keeping up with. At least, that's my own personal strategy." And your being a doctor would certainly give you more credibility in making that statement to another doctor than I would have...!
In any case, thanks again for your very thoughtful comment!

Mark,
I also strongly agree with your message and the comments thus far. Modern life has become mind numbing. I addressed this with helpful tips to address it with "Want to go faster? Use the brakes MORE! Paradox #4017: Disciplines to not be 'CrazyBusy' "

Since then, I've found another treatment that addressing the mind numbing world. It's David Allen's Getting Things Done (sometimes referred to as GTD, or Halamka's secret sauce). Again, it's very pragmatic and actionable treatment of stuff overload (not just information overload.)  Having your inbox spread over your desk, home, office, briefcase, voicemail and 'in-your-head' is extremely mind numbing, all by itself.  It raises the question, what does your friend's world look like?  Is it organized, neat, or both?  If it's neat and not organized, that's much more mind numbing than information overload.

On a personal note, about 2 years ago, I was asked to put together a presentation on the 10 year horizon for where EMRs were going. I spent hours on it and I used a lot of articles from the Wall Street Journal, since they often document investments with pay-offs in that time range. The room full of physicians received CME credits for attending and there were no product references or EMR company visions represented. You get the picture.

I even drew some new connections. For example, I discussed the implications of MediCare Part D on e-prescribing (hundreds of formularies to comply with with relatively dynamic coverage.) Practice without e-Prescribing becomes logistically impossible. I also discussed e-Prescribing and adaptive trials again, impossible without computerized medicine.

I got a lot of thanks and praise after the presentation. That felt good. But that said, one physician came up to me in an extremely sober tone, neither kind nor unkind, and he said "it must be nice to have time to read."

How would you suggest I respond to that comment?

Bravo Mark. I would even add that CIOs who feel they are "covered" by the position statements of groups to which they belong (CHIME, etc), should review those statements to see if their opinions are sufficiently represented. If those statements leave something to be desired, it is incumbent upon all CIOs to send their own comment letters when the meaningful use guidelines are presented to the public for feedback.