Tuesday, February 11, 2020

Preparing for My Birthday 2020

I’m putting an end to my health tech consulting and creating space for what comes next. Nurturing new things is not a part-time activity. Birth requires a commitment to create what comes next.

I’ll be doing one last round of on-line meetings with my health IT partners this month. After that, I’ll be available for continued friendship and touching base on the human aspects of our lives, not so much the organizational or technical parts, though sometimes those are inseparable. It’s awkward and scary to make this explicit, though it’s really how I’ve been functioning for the past few months.

I will have fully established this next phase by my birthday, 23 June 2020. It likely will include lots of art and a fuller integration of the many parts of my life (as a gay man, as a photographer, as a meditator, as a human engaged in the world).

After a lifetime of working in health IT, there are areas that I am still passionate about (health equity, technology that approaches magic).  Where these emerge organically, rather than as goals in their own right, they will surface on this blog.

Follow my journey at www.larrywolf51.com as well as on Instagram (@larrywolf5151).

I offer you this poem as inspiration.

Clearing — Martha Postlewaite

Do not try to save
the whole world
or do anything grandiose.

create a clearing
in the dense forest
of your life
and wait there
until the song
that is your life
falls into your own cupped hands
and you recognize and greet it.

Only then will you know
how to give yourself
to this world
so worth of rescue.

Wednesday, February 13, 2019

Taking My Own Advice

Chief Enthusiasm Officer - Adviser, Facilitator, Coach 

I'm at HIMSS19 in Orlando, putting my notes on Twitter, handing out my overgrown business card, catching up with friends and seeing what resonates.

The conversations that matter, where there is a heart connection:
  1. How can I help? ... Stay curious, stay engaged, see what opens up.
  2. Change out my photo to one that show's me glowing with energy.
  3. The only now is this one! People want to be more "meditative" and need encouragement to acknowledge the times that their mind and body are synchronized, when they are in the present moment. It's not about a still mind, it's about being alive. Let's not make our expectations of nirvana blind us to the life we're actually living. ... I may take a month to dive deep into stillness, but that's not the only time or way to be present.
  4. Break through the false ceilings! Regulations get interpreted very literally. Providers and vendors do the minimum to stay out of trouble. ... Along the way, we've put in place some powerful technology. Time to build on that and achieve the game changing value that's embedded in it. 
  5. It's about people and culture. Let's focus on what's working, where we have teams delivering care and improving people's lives, where we have tech that is invisible in how well it performs.
  6. Getting value from data is a soapbox I keep jumping up on... Find the patterns that matter to direction action.
  7. Too much data is un-mediated and we're drowning in a sea of riches... Use people + process + technology to make sense of it. Not one of those alone. 
  8. The person (their medical record) can be the textbook on what's good for them. More than genomics, this is about each of us being our own normal, about the tech finding our patterns, about the person being clear about our own goals and desired outcomes, having the tech guide our care team.
  9.  ... The list keeps growing 😀

At the Core - Where is the energy naturally arising?

Culture eats strategy for breakfast, lunch and dinner.
  • Clarify Mission & Vision
  • Build on Culture
  • Act Strategically
  • Adjust with Feedback
  • Deliver Results

Tuesday, April 11, 2017

National Academy of Medicine - Vital Directions for Health and Health Care


Every once in awhile, the National Academy of Medicine (formerly known as IOM, the Institute of Medicine) has published an era-defining paper or book (for example: To Err Is Human: Building a Safer Health System (2000) and Best Care at Lower Cost: The Path to Continuously Learning Health Care in America (2013)).

On March 21, 2017, they issued a new report: Vital Directions for Health and Health Care (2017). It is the culmination of many workgroups over the past year or so. It brings together the thinking of a wide range of experts.

NAM Vital Directions - Overall Summary: Vision, Goals, Actions, Infrastructure

Better Health & Well-Being

A strong message of the report is to focus on better health and to look broadly at what that means and what leads to good health. 

Determinants of Health

NAM Vital Directions - Figure 5: The leading health determinants.
SOURCE: Adapted from McGinnis, 2002

The usual reaction to improving health is to jump to care as the primary driver of health. However, there is growing recognition that our health, and the health of the population as a whole, depends on much more: our genetics, our behavior and our social and physical environment. While the healthcare system can provide decisive intervention at critical moments, there are many other factors that must also be addressed. We have to address acute crises, chronic conditions as well as economic, social and educational status and access to services and information. Living a good life is about acting on the values of the individual and broad support provided by their multiple communities.

McGinnis, J. M., P. Williams-Russo, and T. R. Knickman. 2002. The case for more active policy attention to health promotion. Health Affairs 21(2):78–93.

An earlier post put forward the interaction of being, doing and environment. It reframes the determinants into three areas of influence - our inner experience, our actions and the world around us.

The Action Priorities 

The report has a long list of action priorities. Here are a few highlights.
  • Pay for value - Deliver better health and better results for all
  • Remove barriers to integration of social services with medical services
  • Link care and personal context
  • Ensure patient data access, ownership and privacy
  • Connect Care - Implement seamless digital interfaces for best care
  • Measure What Matters Most - Use consistent core metrics to sharpen focus and performance
  • Accelerate Real-World Evidence - Derive evidence from each care experience
  • Foster a culture of data sharing by strengthening incentives and standards
Future posts will address these and other areas of the report.