Interviews Live From HIMSS 2019
This week I am talking to several guests live at HIMSS 2019
Rasu Shrestha, MD EVP & Chief Strategy Officer Atrium Health (@RasuShrestha), R. Hal Baker, MD SVP, CIO Wellspan, and Aneesh Chopra, President, CareJourney (@aneeshchopra)
Listen in to hear their thoughts on the latest innovations at HIMSS, what’s coming, the importance of shared values, bringing the humanity back to healthcare and the importance of bipartisan consensus on interoperability.
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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Listen along on HealthcareNowRadio or on SoundCloud
Interviews Live From HIMSS 2019 was originally published on Dr Nick – The Incrementalist
Has Kindness Gone?
Where has the Kindness Gone
As someone remarked to me just recently
The kindness has gone
It can certainly feel that way sometimes and while my general position is to think like a proton – always positive it has been challenging over the last few months to maintain this position.
I posted this over the weekend: “You don’t have to attend every argument you are invited to”
You don’t have to attend every argument you are invited to#life
— Nick van Terheyden, MD – The Incrementalist (@drnic1) February 24, 2019
https://platform.twitter.com/widgets.js
And around the same time, Linda Stotsky (@EMRAnswers) posted this: “In a world where you can be anything, be kind.” #SundayThoughts #SundayBrunch #SundayMorning
“In a world where you can be anything, be kind.” #SundayThoughts #SundayBrunch #SundayMorning pic.twitter.com/vD2FCQ6HnK
— Linda Stotsky (@EMRAnswers) February 24, 2019
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Both received a fair amount of (mostly) positive endorsements which affirmed my view that there is a desire of many/most to be positive, but was followed by some posts from Casey Quinlan (@MightCasey) and Dave DeBronkart (@ePatientDave) highlighting this horrific expose on the people employed to do content moderation that reads like a horror movie (The Trauma Floor).
However it was the piece on NPR Radio: Anger Can Be Contagious – Here’s How To Stop The Spread by Alison Aubrey (@AubreyNPRFood) – which in some respects feels titled incorrectly because the ultimate point is that:
Kindness is transmissible
That reaffirmed my belief that the kindness is there is just not getting through.
I’ve lost count over the last few months of the repeated instances of individuals and groups jumping in, oftentimes absent facts excoriating the latest target and the inevitable mass of people who then jump in on both sides, certain of their position and argument. In some cases, the action or behavior was mean or unkind and the mob certainly made sure to let that individual know often succeeding in trashing someone’s personal and work life creating meme’s that live on forever. There are plenty of examples but I see little point in calling further attention to them, the individuals and groups but rather focus on how we can all perhaps contribute to a kinder world
Perspectives
Almost every time these instances occur I am reminded of an advert (Points of View) from the 1980’s for the Guardian newspaper, that thanks to the wonders of the internet time machine are available to view. At the time it hit a resonant note with me emphasizing the importance of perspective and the lens we all view life through – everyone’s lens is different and shaped by personal experiences, connections and emotions many of which are invisible to others
Incremental Steps to a Happier Kinder World
Taking a page form my daily meditation teaching and one of their guidance points as you start to feel overwhelmed or anxiety approaches they say
1) STOP
- S is for Stop
- T is for Take a breath
- O is for observe, referring to observing whatever caused the stress or anxiety
- P is for Proceed
2) Try to Put Yourself in Someone Else’s Shoes
And I’d add another step in the process – try and imagine yourself in the other person’s shoes. I always encourage taking a walk in someone else’s shoes in an attempt to get a sense of what might be driving their thoughts and ultimately their behavior. We are all imperfect (at least I know I am and there are plenty of opportunities for improvement and reflection and my life is replete with mistakes and things I regret in hindsight).
If you observe something or someone behaving badly – it might be hard to imagine yourself in their shoes and to explain the behavior or actions but if nothing else trying to do so will always inform you and any response you have.
3) Do Something Nice for Someone Else
Given that kindness is transmissible try being kind to people online and in person. A simple smile aside from helping lift your own mood helps lift others moods and in most cases, people respond by smiling back which lifts your mood further.
Take a leaf out of the “Pay it Forward” movie and find something to do for someone else – you might be surprised at how good it makes you feel
Anger leads to more anger. But a single act of kindness can help stop the spread.
https://static.medium.com/embed.jsView story at Medium.com
Has Kindness Gone? was originally published on Dr Nick – The Incrementalist
Design Thinking for Healthcare and Medical School
Design Thinking for Healthcare and Medical School
This week I am talking to Dr. Clay Johnston, MD, PhD (@ClayDellMed), Dean, Dell Medical School and Vice President for Medical Affairs, UT Austin. Dr. Johnston has been the inaugural dean of Dell Medical School and is working towards a vision to create a new model for academic medicine that accelerates innovation to improve health and reduce inefficiencies in health care.
Find out how they set their vision and as Dr. Johnston describes the importance of making this a worthy vision and the associated difficulty with achieving that goal and what that means to your incremental steps to getting there. You can hear about their new Design Institute lead by Stacey Chang, who came from the innovative design house IDEO to run the design institute. You incremental learning point from the Design Institute:
“Don’t Assume you know”
You can hear about the Dell Medical Schools unique recruitment methods that help them find the students who are well suited to the new age of medicine – hint its not your MCAT score, how they screen and then how they have changed up the medical curriculum to offer a whole new system to nurture innovation and new thinking in our future doctors so they are well equipped to work in our new world of DigitalHealth
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Design Thinking for Healthcare and Medical School was originally published on Dr Nick – The Incrementalist
Stemming the Tide
The Opioid Epidemic
130 people die from an overdose of an opioid every day in the United States. Death from overdoses reached a staggering 47,600 people in the United States in 2017 – to put that into perspective that’s a 130 people per day, or 1 person every 11 mins, and now in the top 10 causes of death in the United States. The problem has been getting worse with an increase in preventable opioid deaths of 26% in 2016 which is only overshadowed by the 544% increase we have seen since 1999.
The background and causes to the problem are varied but in many cases, the start of addiction begins with medically prescribed medication and far too frequently end tragically with death from overdose. With the rising incidence, the epidemic is having a wide impact with barely anyone left untouched.
For some struck by tragedy, such as Ed Kopetsky, the CIO for Stanford Children’s Health, Lucile Salter Packard’s Children’s Hospital, they have turned devastation into a drive to action. Ed sadly lost his son, Jim, to an overdose following a history of exposure to opioids that dated back to high school. Take a look at the video of two of the stories from CHIME members here.
“If we can save just one more person from that addict path by speaking up and using our voices and using the power of CHIME and the power of the people all united to try to change, I think we will make a difference”
Together with his colleagues and friends from CHIME they formed the CHIME Opioid Task Force. Their mission is to harness the unique insights and assets of their healthcare leaders and institutions to make a real difference to address the crisis. They are united in their goal of combatting the increasing addiction and growing mortality of the Opioid Crisis by raising awareness, publicizing leading healthcare practices, providing data for medical research, policy advocacy and leveraging our leadership talent in unique and powerful ways.
NTT DATA Give Back
NTT DATA has a long history of giving back to worthy causes and this year at HIMSS19 as joined forces with The CHIME Opioid Task Force, DisposeRx (who offers a unique and safe method for disposal of unused or expired medications) and Luster Mosaics to create a mosaics picture from individual user-contributed pictures posted on Twitter and Instagram.
For every post using the hashtag #NTTDWhyICare NTT DATA is donating $5 (up to 15,000) to the CHIME Opioid Task Force and will use the pictures to create a unique mosaic image live on the show floor. To get involved, simply snap a shot, post it to Instagram or Twitter using #NTTDWhyICare with a statement about why you care.
You can click here to create a tweet with the correct hashtag
Or this link: Tweet #NTTWhyICarehttps://platform.twitter.com/widgets.js
Join in at HIMSS 2019
Stop by booth #3301 at HIMSS19 in Orlando to see the mosaic as it gets put together and see if you can find your picture. While you are there, pick up a DisposeRx packet and see how easy and effective it is to safely dispose of any medication in your home.
Come join us for a reception on Wednesday, February 13 at 5:00 pm EST at the NTT DATA HIMSS19 booth #3301 as NTT DATA and DisposeRx present a check and reveal the completed hashtag-driven social media mosaic art to the CHIME Opioid Task Force.
If you’d like to donate directly to the CHIME Opioid Task Force, you can do so here
Stemming the Tide was originally published on Dr Nick – The Incrementalist
Summit
Keys to Successful Conferences
How do you describe the CNS Summit and what it offers – the word impossible springs to mind. Even the name can be a little misleading especially for medical folks who might look at that and think “Central Nervous System” but actually its stands for Collaborating for Novel Solutions
This coming year will be the 10th year of the event and it continues to get better – testing new ideas and concepts for conferences to make the event valuable on multiple levels. The history and experience reminds me a lot of friendships and how they develop – the first interaction can be awkward and uncertain but intuitively you get a sense that the person you are talking to is someone who will be a friend pretty quickly (science suggests it is not minutes or seconds but a 1/10th of a second). Over time the relationship deepens and you learn more, and understand more, and how much you enjoy working with, learning from, sharing and sometimes just hanging out. So it is with the CNS Summit or more frequently know as “Summit”.
Where else can you come to a conference and get clever new ideas and techniques on how to use your mobile phone camera in interesting and creative ways from the incredibly talented and inspiration photographer Asa Mathat (recommend instagram @AsaMathat to get a sense of his incredible lens on the world and people). He is a renowned Photographer to the stars, creator of the big pink ribbon and at Summit – photographer for attendees as well!).
(Hint – Don’t think in traditional planes of movement and use your volume buttons as triggers and when you reach the end of your panorama, just reverse direction to switch it off).
Areas Covered
It hard to categorize the conference into a bucket – it benefits from being not too big so as not to overwhelm but large enough to attract an impressive diversity of participants and speakers. The mix includes leaders from the Pharmaceutical Industry, digital health, medical and device companies and technology companies.
Insights continued from cancer survivors who parlayed their personal experiences to focus on taming the data mountain in healthcare and science, the pharmaceutical executive who nearly died from a side effect of a drug that had a life changing effect on the personal trajectory that allowed for a rethinking the model of industrial production of pharmaceuticals.
Of course for this Whisky Librarian, there is even a special highlight put on by Woody Woodaman – the whisky tasting that raises money for a fund set up in his wife’s name Betty Jean Memorial Scholarship Fund to support nurse training. The conference floor is always offers new concepts and technologies – everything from taste experiences to the highly popular hugging booth set up by friend and colleague Andrew Chacko.
Each year is an eye opening experience full of surprises that Amir Kalali the conference Chief Curator keeps close to his chest like a proud parent who know’s he’s picked the best birthday gift for their child and can’t wait to reveal it.
This year there were many mind blowing presentations – for me “Breaking the Logjam in Medical Imaging” by Mary Lou Jepsen from Openwater that pushed the boundaries of wearables by offering a path to an MRI wearable. Sounds far fetched – not if you approach the problem with a different lens and understand that our photo sensor chips have reached a sensitivity of a micron – the wavelength of infrared. Combine this with the fact that our bodies are translucent to red and near infrared light – but red light scatters but this is not random, it is deterministic and reversible if you can record a hologram of it. So with some clever use of relatively old technology that allowed us to move from overhead foils
to LCD projectors we are all accustomed to. This now allows the generation of ultrasound waves from small devices and using the change in phase of the light as it passes through the red light (you all know the doppler shift experiment you learnt in physics at school) they are now able to find vasculature at higher resolution than MRI and fMRI and even have additional capabilities to differentiate between oxygenated and non-oxygenated blood as achieved with the fMRI
But the resolution is now down to a few microns which is at the size of neurons, meaning they have the ability to see into our bodies at the detail of our nervous system… real time!
Combined with the early science that shows we can reconstruct what we are thinking and seeing based on analysis of our brain activity (Reconstructing visual experiences from brain activity evoked by natural movies, Nature – pdf). Most exciting the project is driven by a challenge to deliver a low cost, better imaging solution, to everyone, given that 2/3 of humanity lacks access to imaging.
Final Conference Day
The highlight for me was the last day – which according to my research and discussions with others, is just like every other conference poorly attended with many people missing the best elements.
It included two amazing presentations by the compassionate and gentle Daniel Friedland (Leading Well from Within), the wonderful, funny and insightful Chris Hadnagy (Social Hacker and previous guest on my radio show) and Stephanie Paul’s fun and eye opening Improv experience and included Asa Mathat participating and recording the activities with his unique eye. This picture captures the fun and learning we had as we learnt and connected
So my Incremental step for you is set aside Oct 31 – Nov 3, 2019 for Summit 2109 (It is the 10th anniversary so I’m imagining Amir and the guiding council is thinking hard about making this event super special) and you to will have the learning opportunity and fun as you find a new friend in CNS Summit
And one more Incremental step – if you are taking the time to go to a conference, don’t head out before it finishes but rather plan to enjoy the last sessions where organizers often try to save the best till last.
Summit was originally published on Dr Nick – The Incrementalist
Why Healthcare Needs More Women Leaders
Women as the Key Healthcare Decision Makers
This week I am talking Lisa Suennen, (@VentureValkyrie) Managing Partner of Venture Valkyrie, LLC, an advisory firm that works with healthcare and other companies on investment and innovation strategies and host of the Tech Tonics Podcast. Lisa is a twenty year veteran of healthcare investment, healthcare technology and venture funding and a history with behavioral health company that was treating 35 Million people.
This interview arose from on twitter discussion
1. Pick a female colleague
2. Describe why she’s awesome
3. Use the hashtag #ThisWomanRocks
Let’s hear about a ton of cool women! https://t.co/rC5n78LfZ3— Esther BOO!, MD MPH (@choo_ek) August 29, 2018
featuring #ThisWomanRocks that I nominated Lisa and several others for and I asked them to join me on my show to share their experiences and thoughts on how we change the poor representation of women. In the Venture capital world when Lisa joined the statistics were dismal – only 8% of Venture Capitalists were women – 20 years later, its still about the same!
This despite the fact that gender diverse companies show better financial performance – so its not just good to do its the best for the bottom line too. As Lisa highlighted, Kevin O’Leary (aka as M.r Wonderful on Shark Tank) has highlighted the fact that in all the companies he is involved in – the ones with gender equity and women backed are far more successful on multiple measures.
So why are we still seeing dismal representation for women and what incremental steps can we take to improve this – listen in to hear what Lisa has to say and why in healthcare especially this should be a prime directive (hint – think about who makes the majority of healthcare decisions for any family)
As we discussed, the way to get more women onto the stage and engaged is to be part of the solution and there is no better way than signing up with CSweetner, a not-for profit organization dedicated to helping women benefit from mentorship to become the best leaders they can be and offering a speaker bureau for conferences to find women speakers
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Why Healthcare Needs More Women Leaders was originally published on Dr Nick – The Incrementalist
Making it Easier to do the Right Thing
Behavioral Health for Positive Impact
This week I am talking to Matt Wallaert (@mattwallaert), Chief Behavioral Officer at Clover Health. I have listened to Matt on a few occasions, most recently at the FitBit Captivate event in Chicago so I was excited to get to talk to him one on one.
Matt plays an unusual and atypical role in Clover Health – he is their Chief Behavioral Officer, a title and role that is not commonly found. He is a Social Psychologist who focuses on Judgement and Decision Making and is most well known for applying behavioral science to practical problems.
We explore behavioral health influences and how we can create interventions that will have a positive impact. How do we create incremental steps and test these and then roll out of programs to have a positive impact on health? He wanted to have an impact and wanted to make things better for people and over the course of his career has managed to do so in many places but is now focused on healthcare and specifically personal health. There’s a recurring theme in many of my INcremental interviews and I heard it again from Matt:
Assume you are going to fail
As Matt puts it – “don’t set up a durable process – for example, if you are doing a mailing do that yourself vs getting your marketing department to create the mailing”. Then head out to the next step – a Test. It is not hard to find behavioral changes that work – but that’s not the only requirement as the change has to work well enough and are scalable enough that you really want to roll them out widely.
Incremental Step to Behavioral Health
It’s not just finding good behavioral changes but rather things that are worthwhile and scalable
“If behavior is your outcome and science is your method – then you are a behavioral scientist”
As Matt says we have to make it easier to do the right thing and not blame individual choices and health behaviors when we make poor health, decisions. Listen in to find out why there are significant cultural differences in flu vaccination take up rates and what incremental steps can be taken to improve on that and hear why it is important not to blame people for poor health behaviors. Learn how they are behaving like Netflix or Pandora that can can match you to the right videos or music we should be able to match you to the right doctor
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Making it Easier to do the Right Thing was originally published on Dr Nick – The Incrementalist
Is Intermittent Fasting Right for You?
Does Intermittent Fasting Work?
This week we I’m covering the world of Intermittent Fasting. What’s that you ask – in its simplest form
Eat – Stop – Eat
In other words, challenging your body with no intake of calories for a variable amount of time. In my case I fast for about 36 hours with my last meal in the evening of day 1, I eat nothing on day 2 but do drink plenty of water and allow myself coffee and tea but without any milk (or sugar) and my next meal is breakfast on day 3
But there are plenty of variations on this that range from the 5:2 program that has you eating 5 days and fasting 2 days but non-consecutively and in some cases allowing for a small number of calories (500-100) or the 18 hour fast where you only eat food between the hours of 12 and 6 pm and fast the remainder of the time through to some who fast for more than a day.
Listen in to the video to find out what are the good things about intermittent fasting and what are the downsides and what the various types of intermittent fasting methods are and how you might take an incremental step and try them out.
If you are interested in finding out more I have linked to some additional papers and articles to give you some more reading
Links to Studies on Intermittent Fasting
Harvard study shows how intermittent fasting and manipulating mitochondrial networks may increase lifespan
Intermittent fasting promotes adipose thermogenesis and metabolic homeostasis via VEGF-mediated alternative activation of macrophage in Mice
Is fasting the fountain of youth?
Study Fasting for 72 Hours can Regenerate the Entire Immune System of Humans!
Can I ask a favor – if you like the video, please subscribe to my channel, and if you don’t leave me your feedback/thoughts on how I can improve things?
Is Intermittent Fasting Right for You? was originally published on Dr Nick – The Incrementalist
The Healthcare Huddle
Delivering the Care Patients Want
This week I am talking to Dr. Jay Mathur, Associate Regional Medical Director for Caremore Health Systems in Connecticut. A program that started 25 years ago in California and has now expanded to multiple states and has been in Connecticut for a little over a year. This is the medicine that we went to medical school to practice, the opportunity to deliver the care that patients and families want.
We know that the poor typically live alone and quite often socially isolated and their zip codes play a part in their health status but sometimes it can be their shopping experience and availability of food not just their zip code that is a key determinant of health. We talked about some of this in my interview with Dr. Won Chun from Carrot Health
Listen in to hear how they select the hardest patients with the most complex diseases and chronic conditions as and learn the key elements in their success that are tied to the early morning huddle where everyone shares the upcoming day, tasks and resource allocation getting everyone on the same page. All I could think of was the scene from The Replacements and Shane Falco’s huddle:
Huddle Fight
They have a range of team members with their Clinical Partners as the glue that keeps everything together and others on the team including Social Workers, Psychiatrists, Case Managers and physicians playing a supporting role to each other
Glory Lasts forever
From a patient standpoint, it all starts with a detailed assessment and importantly introducing all the team members to the patient using a range of technology tools to facilitate and improve efficiency
Their Incremental steps to improvement include the huddle but listen in to hear what other incremental steps you may be missing that has added significantly to their team-based approach, coordination and success
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next two weeks at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
The Healthcare Huddle was originally published on Dr Nick – The Incrementalist
Mindfulness and Meditation
This week we are focusing on mindfulness and meditation and why it is important for your health. People that include mindfulness and meditation in their daily routing find they are better able to deal with pain, have improved immunity, sleep better, lower their blood pressure and have less inflammation.
What are the Incremental steps to get you into a regular habit of mindfulness and meditation – the first step is to find what works for you. What’s the best time and where is the best place that works for you? Once you have decided where and when, like most other incremental steps it requires you to take that first step. It can be hard and one of the important things is to understand that you don’t have to do it for very long – even a few seconds can be helpful and then work up to longer times.
There are a range of apps you can download to help you start including some great free apps and I talk about some of those choices and options
Here are 5 free apps you can download that can help you get started
Can I ask a favor – if you like the video, please subscribe to my channel, and if you don’t leave me your feedback/thoughts on how I can improve things
Mindfulness and Meditation was originally published on Dr Nick – The Incrementalist
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