The core message in this post: Beware the leader too comfortable in the role, too adept at eluding the grasp of humility.
After a recent guest lecture, one of the students approached me afterwards and asked me for advice about leadership and management. She was about to become a first-time manager and leader for a six-person team. Later, she emailed me about the same topic. Below is my reply to her. "Simply because you care about these issues of true leadership and are willing to study, think, and put forth the effort to become a good leader, immediately places you in a favorable position. You will succeed, almost certainly, as a natural consequence. But, whatever advice you take or book you read, ask yourself, "Do I serve those I lead, or do those I lead serve me?" It's a pretty simple question that boils everything extraneous about leadership and management away.
The point of this commentary is: Purchasing and installing an EMR and hoping that you’ll realize a positive return-on-investment is not enough. You need to dedicate the time and resources to constantly iterate, refine and improve the utilization of that EMR over time, far beyond its installation and go-live. It’s a race without a finish line so you might as well train, budget and plan for that accordingly-- up front.
Amazon.com announced today that it will develop a new Electronic Health Record based upon the same user interface experience and underlying information technology that it uses to support its global ecommerce business.
Following the model of healthcare systems that have managed to optimize the cost of care with the quality of care—such as Kaiser, Intermountain, and
Several days ago, I passed around a survey to gauge people's concerns about protecting their private information. The survey is now closed and you can see the results and comments here: Survey Results. In summary, 92% of respondents were more concerned with “Protection of my personal identity and financial data” vs. 8% with “Protection of my electronic health record data.”
I have this theory that we (healthcare) could learn from retail in terms of customer relationship management, in a variety of ways. For example, in retail, almost every store has a “Top Customers” report that lists their top customers over the past year, month, and week. They calculate “top” by total purchases and by the number of customer visits to the store or web site. In theory, retail companies treat these “Top Customers” differently, either through targeted marketing or in some cases, “red carpet” treatment and gratis benefits. I sense that the leaders in the hospitality industry engage in this type of personalized process behavior, too.
If you haven't read the March 27 JAMA commentary from Ross Koppel and David Kreda, you should track it down. In summary, they point out very appropriately, that there are patient safety issues associated with the use of EHRs, and that HIT vendors should not be allowed to contractually walk away from their safety obligations in the design and implementation of their products. I agree with the commentary and add that the obligations for patient safety don't end with the vendors; we HIT customers are obligated, too.
We've spent gazillions of dollars on HIPAA Security compliance-- some needed, but some of which I think we contrive for no good reason... screening and trapping outbound email for HIPAA-sensitive terms is one of those risk mitigators that, to me, has incredibly low value. As we get our security feet on the ground in healthcare, we tend to spend big bucks locking the front door while leaving the backdoor wide open.
T. Allan Pryor was one of the "inventors" of Intermountain Healthcare’s HELP electronic health record system.