HIMSS Recap

I’ve gone through all of my notes, reviewed all of the presentations and am feeling really good about my experience at HIMSS.

Takeaways:

  1. We need to get ADT enabled for the local hospitals
  2. We need to have a governance system set up for a variety of things, including data, reporting, and IT based projects

Below are the educational sessions (in no particular order) I attended and my impressions. Mostly a collection of interesting facts (I’ve left the Calls to Action for my to do list).

Choosing the Right IT Projects to Deliver Strategic Value presented by Tom Selva and Seth Katz they really hit home the idea that there is a relationship between culture and governance. The culture of the organization has to be ready to accept the accountability that will come with governance. They also indicated that process is the most important part of governance. Without process you CANNOT have governance.

In addition to great advice, they had great implementation strategies including the idea of requiring all IT projects to have an elevator pitch and a more formal 10 minute presentation on why the project should be done and in what way it aligned with the strategy of the organization.

Semantic data analysis for interoperability presented by Richard E. Biehl, Ph.D. showed me that there was an aspect of data that I hadn’t ever had to think about. What to do when multiple systems are brought together and define the same word or concept in different ways. Specifically,, “Semantic challenge is the idea of a shared meaning or the data that is shared”. The example on relating the concept of a migraine from ICD to SNOMED and how they can result in mutually exclusive definitions of the same ‘idea’ was something I hadn’t ever really considered before.

Next Generation IT Governance: Fully-Integrated and Operationally-Led presented by Ryan Bosch, MD, MBAEHS and Fran Turisco, MBA hit home the idea of Begin with the End in mind. If you know where you’re going it’s much easier to know how to get there. This is something I’ve always instinctively felt, however, distilling it to this short, easy to remember statement was really powerful for me.

Link to HIMSS Presentation

Developing a “Need-Based” Population Management System presented by
Rick Lang and Tim Hediger hammered home the idea that “Collaboration and Partnering are KEY to success”. Again, something that I know but it’s always nice to hear it out loud.

Link to HIMSS Presentation

Machine Intelligence for Reducing Clinical Variation presented by Todd Stewart, MD and F.X. Campion, MD, FACP was one of the more technical sessions I attended. They spoke about how Artificial Intelligence and Machine Learning don’t replace normal analysis, but instead allow us to focus on what hypothesis we should test in the first place. They also introduced the idea (to me anyway) that data has shape and that shape can be analyzed to lead to insight. They also spoke about ‘Topological Data Analysis’ which is something I want to learn more about.

Link to HIMSS Presentation

Driving Patient Engagement through mobile care management presented by Susan Beaton spoke about using Health Coaches to help patients learn to implement parts of the care plan. They also spoke about how “Mobile engagement can lead to increased feeling of control for members” These are aspects that I’d like to see my organization look to implement in the coming months / years

Link to HIMSS Presentation

Expanding Real time notifications for care transitions presented by
Elaine Fontaine spoke about using demographic data to determine the best discharge plan for the patient. In one of the presentations I saw (Connecticut Hospitals Drive Policy with Geospatial Analysis presented by Pat Charmel) the presenter had indicated that as much as 60% of healthcare costs are determined by demographics. If we can keep this in mind we can help control healthcare costs much more effectively, but it lead me to ask:

  • how much do we know
  • how much can we know
  • what aspects of privacy do we need to think about before embarking on such a path?

Link to HIMSS Presentation

Your Turn: Data Quality and Integrity which was more of an interactive session when asked the question “What would a National Patient Identifier be useful for?” most attendees in audience felt that it would help with information sharing

Predictive Analytics: A Foundation for Care Management presented by Jessica Taylor, RN and Amber Sloat, RN I saw that while California has been thinking about and preparing for value based care for some time, the rest of the country is just coming around to the idea. The hospital that these Nurses work for are doing some very innovative things, but they’re things that we’ve been doing for years. The one thing they did seem to have that we don’t is an active HIE that helps to keep track of patients in near real time. I would love to have! One of the benefits of a smaller state perhaps (they were from Maine)?

Link to HIMSS Presentation

A model of data maturity to support predictive analytics presented by Daniel O’Malley, MS was full of lots of charts and diagrams on what the University of Virginia was doing, but it was short on how they got there. I would have liked to have seen more information on roadblocks that they encountered during each of the stages of the maturity. That being said, because the presentation has the charts and diagrams, I feel like I’ll be able to get something out of the talk that will help back at work.

Link to HIMSS Presentation

Emerging Impacts on Artificial Intelligence on Healthcare IT presented by James Golden, Ph.D. and Christopher Ross, MBA. They had a statistic that 30% of all data in the world is healthcare data! That was simply amazing to me. They also had data showing that medical knowledge doubles every THREE years. This means that between the time you started medical school and the time you were a full fledged doctor the amount of medical knowledge could have increased 4 to 8 fold! How can anyone keep up with that kind of knowledge growth? The simple answer is that they can’t and that’s why AI and ML are so important for medicine. But equally important is how the AI/ML are trained.

Link to HIMSS Presentation

HIMSS review

I had meant to do a write up of each day of my HIMSS experience, but time got away from me, as did the time zone change, and here I am at the end of HIMSS experience with only my day 0 notes down on paper.

Day 1 started with a rousing Keynote by Ginni Rometty, the CEO of IBM. The things that struck me most about her keynote were here sense of optimism about the future sprinkled with some caution about AI, Machine Learning and Big Data. She reminded us that the computers that we are using for our analyst is are tools to help, not replace, people and that it is incumbent upon us, the leaders of HIT, to keep in the front of our minds how these BIG Data AI/ML algorithms were trained. As the old saying goes, “Garbage In, Garbage Out”

I also was able to record a bit of her keynote speech just in case I need to find and listen to it later.

I tweeted a couple of times during the keynote (and even got some likes and retweets … not something I’m used to getting)

Transparency in the Era of Cognition with the help of @ibmwatson #himss17

Artificial intelligence is out of its winter ... I sure hope so, but time will tell #himss17

Integration in workflow is the key to adoption #himss17

Don't let others define you. Great words from @GinniRometty #himss17

Growth and comfort never coexist. Another great gem from @GinniRometty #himss17

I spent almost all of my time on day 1 in educational sessions. One things that I noticed from my first class was just how FULL it was 15 minutes before the session even started!

The Emerging Impacts of AI on HIT was full 15 minutes before the session started! Something tells me lots of ppl interested in AI #HIMSS17

Sometimes the session title were a bit misleading, but eventually most of them would come around. A class with a title of Connecticut Hospitals Drive Policy with Geospatial Analysis was more about the Connecticut Hospitals and less about the Geospatial Analysis, but in the end I was what I was hoping to see which was people using Geospatial Analysis to help identify, and perhaps risk stratify patients to give the best care possible.

My tweet when the class was over:

Great talk on #geospatial analysis. So many ideas floating through my head now on potential actions and analysis #HIMSS17

I ended my HIMSS 2017 experience on a high note with a great session titled Choosing the Right IT Projects To Deliver Strategic Value. I’m still processing everything that came out of that session, but it left me feeling very positive about the future. It was nice to have the same, or at least very similar, feeling of optimism at the end of HIMSS as I had at the beginning after Mrs. Rometty’s Keynote.

I’ll be writing up my notes and linking to the presentations later this week (maybe whilst I’m flying back home to California tomorrow).

This is a conference I am overwhelmed by but am glad I am coming to.

While it’s fresh in my mind, strategies for next year:

  • Pick 1 – 3 strategic challenges you want to solve. Then identify 10 – 20 vendors that can help solve that problem. Talk to them, schedule appointments with them. Get more information than you know what to do with
  • Work on being a presenter. It will help check off that ‘Speak in front of large groups of people’ item on your Bucket List

HIMSS 2017 – Day 0

I'm in Orlando for HIMSS17 and and pretty pumped for my day one session tomorrow which is titled: Business Intelligence Best Practices: A Strong Foundation for Organizational Success.

Conferences are always a bit overwhelming, but this one is more overwhelming than most. More than 40,000 people all gathered in one convention center to discuss Healthcare Tech. Kind of awesome and scary!

I'm looking forward to visiting some booths in the exhibition hall, and wandering around and stumbling onto some great new things / ideas.

I'm going to write up my impressions of the days events, hopefully including notes, and links to tweets because the tweets will be raw and most uncensored impressions of what I'm seeing / hearing.

Here's the HIMSS 2017!

Making Better Meetings … maybe

To say that I attend a lot of meetings is a bit of an understatement. However, as a manager that is part of my job and I accept that it is something I need to do.

What I have been trying to do at my office is lead more effective meetings, but also to encourage my colleagues to have more effective meetings as well.

It's been challenging as the organization I work for is large and all I can do is lead by example with the meetings that I am in.

Until now … maybe

I read an article on LinkedIn titled Tired of wasting time in meetings? Try this and there were several suggestions for better meetings some of which I already knew:

  1. Define the purpose of the meeting
  2. Define the outcome of the meeting
  3. Have a timed agenda and someone in charge

And others that I didn't:

  1. Facts – not opinions!
  2. Keep people on-point. (Only talk about matters relating to their job)

I think that number 4 is a key idea for any meeting (that isn't a brainstorming meeting) but number 5 is a bit too much. Keeping people on point is an important aspect to any meeeting, but only allowing people to talk about matters related to their job … what is the dividing line between 'my job' and 'not my job'?

This seems like it wouldn't actually have the intended outcome. I think people who are already quite will be encouraged to stay quite as the topic isn't related to their job (even if it might be) and those that talk too much already will assume that everything is related to their job so they will still contribute inappropriately.

I think that point 5 is much better when restated as:

  1. Keep people on-point, only talk about the current agenda item

The article did include a nice diagram that you can download (need to provide an email address first).

Success through failure

One of my goals for 2017 has been to read more. According to Pocket I have been in the top 1% of 'pockters' in both 2015 and 2016, but even if that's true (and I'm not entirely convinced it isn't just marketing stuff) what I'm reading are web articles, some long form, but mostly short form articles.

This isn't the kind of reading I want to focus on in 2017. I've got a list of (mostly) science fiction books I'm planning on reading this year.

I'm also listening to audio books through Audible during my commute to work. Those books are a little more varied in their content so far, and exclusively non-fiction.

But why does this matter? As I do I was reading an article on Isaac Asimov entitled Isaac Asimov: How to Never Run Out of Ideas Again – Personal Growth – Medium.

From the article 4 points really struck me:

  • Read widely. Follow your curiosity. Never stop investing in yourself.
  • Diversity is insurance of the mind.
  • We fail. We struggle. And that is why we succeed.
  • After all, never having ideas means never having to fail.

Although I had planned on reading more before having read the article, after reading it I'm even more dedicated to making sure I read as much as I can this year.

The last 2 points are also something I've been trying to work on. One of the reasons for this site is so I can showcase the ways in which I fail and what I am able to learn from those 'failures'.

The ideas that failure and struggle lead directly to success is something I'd never really connected, but I can see the connection between them now.

I like the idea that Isaac Asimov failed at things, but that they didn't prevent him from accomplishing those (and other) things.

This article really helped crystallize an idea that I've had a hard time putting into words …

Failing only happens when you don't try. Trying to do a thing and not achieving that thing is not failing, it's simply a different result than you expected. The success is in the trying.

I don't know if these are the best words, but as I'm learning, the success is in the trying, not in the perfection of the result.

Struggle determines success

On Sundays mornings I wake up pretty early, make myself some coffee and read through all of the interesting articles I came across during the week (usually from Twitter).

Last weekend I came across an article, You probably know to ask yourself, “What do I want?” Here’s a way better question

I was struck by several passages in the article:

If you find yourself wanting something month after month, year after year, yet nothing happens and you never come any closer to it, then maybe what you actually want is a fantasy, an idealization, an image and a false promise. Maybe what you want isn’t what you want, you just enjoy wanting. Maybe you don’t actually want it at all.

 

I wanted the reward and not the struggle. I wanted the result and not the process. I was in love not with the fight but only the victory. And life doesn’t work that way.

 

This is the most simple and basic component of life: our struggles determine our successes. So choose your struggles wisely, my friend.

When I was younger I wanted to be many things, a Physicist, an Archtect, an Engineer, a Professor … but none of those things ever got any closer. I'd be really engaged in the ideas of one of these for weeks or months at a time.

I remember being so enamoured with the idea of Civil Engineering I convinced my parents to get me a drafting board that I had in my room and I used to 'design' a prototype of a Martian Habitat.

But, as soon as I got bored I would move onto something else. From Physics to Archtecture to Engineering and back to Physics. I would always stop when it either got too hard OR something else looked more interesting.

I was always awed by my peers that could stay laser focused on a single hobby or dream job and was amazed at the amount of sacrifice they would be willing to make in order to achieve their goals.

It wasn't until I got to college when I started to see what I needed to sacrifice in order to get ahead.

Parties on the weekend. Not for me … I had a full time job and was a full time student. I would hang with friends when I could, but I was mostly at the library studying, or at work studying or maybe getting a little bit of sleep.

I suddenly became laser focused like the people I knew in high school. I had a single goal and that was to graduate and go onto graduate school so I could get a PhD in economics.

The PhD didn't happen, and in the following years I felt like I did in high school … becoming very interested in a 'thing' and then moving on from it because I'd get bored.

Then I stumbled into the Healthcare Industry and it all came back. An ability to be laser focused on new and interesting things. Wanting (maybe needing) to learn everything I could about Healthcare.

It's been more than 8 years since I started on my journey, and I've struggled every time I've started to learn a new aspect of the industry, or just an aspect of a new job that I had started.

And that's when the final passage in the article really hit me like a ton of bricks:

This is the most simple and basic component of life: our struggles determine our successes. So choose your struggles wisely, my friend.

It truly is the struggle that determines the success. I've struggled mightily while working in healthcare, but those struggles have lead to the most fulfilling and successful career I could have hoped for.

Communication and Checklists

I’ve been thinking about communication … a lot. How well people communicate (or don’t communicate) is what drives nearly every problem, either at work or at home. Communication is essential to a feeling of team which can help to avoid communication problems in the first place. Once you feel like you are on a team, I think it’s easier to engage in communication because you feel more comfortable asking questions, posing challenges when needed, and generally being happier with your surroundings.

I’m almost finished with Atul Gawande’s book The Checklist Manifesto and what struck me the most about it was the fact that checklists used by pilots, construction crews, and surgeons all had one thing in common. They forced communication amongst disparate people helping to start the formation of bonds that lead to a team.

Whether constructing a 32 floor high rise building, flying a 747 or performing open heart surgery, these are all complex problems and they all have checklists.

The use of these checklists help the practitioners focus on what’s important by using the checklist to remind them of what needs to be done but is easily forgotten.

All of this is interesting, but you can get to a ‘so what’ or ‘and …’ point.

While reading Data silos holding back healthcare breakthroughs, outcomes this line caught my attention:

However, the MIT researchers contend that the health data divide can be narrowed by creating a culture of collaboration between clinicians and data scientists

Here’s the ‘so what’ point of all of this. Using Big Data to help patients should be what the healthcare industry is focusing on. But this is difficult because Clinicians and Data Scientists don’t always have the vocabulary nor the incentives to collaborate in a meaningful way that leads to improved patient outcomes.

Could check lists for implementing Big Data at various types and sizes of organizations help? I think so, because at the very least, it could start the neccesary conversations needed to engender a sense of team between Clinicians and Data Scientists which can be sorely lacking in many institutions.

Big Data and Healthcare – thoughts

Healthcare Big Data Success Starts with the Right Questions

The last major piece of the puzzle is the ability to pick projects that can bear fruit quickly, Ibrahim added, in order to jumpstart enthusiasm and secure widespread support.


Healthcare Big Data Success Starts with the Right Questions

Moving from measurement to management – and from management to improvement – was the next challenge, he added. 


Healthcare Big Data Success Starts with the Right Questions

Each question builds upon the previous answer to create a comprehensive portrait of how data flows throughout a segment of the organization.  Ibrahim paraphrased the survey like so:

• Do we have the data and analytics to connect to the important organizations in each of these three domains?

• If we have the data, is it integrated in a meaningful way?  Can we look at that data and tell meaningful stories about what is happening, where it’s happening, and why it’s happening?

• Even if we have the data and it’s integrated meaningfully and we can start to tell that story, do we apply some statistical methodology to the data where we aggregate and report on it?

• If we have the data, and it can tell us a story, and we use good analytics methodology, are we able to present it in an understandable way to all our stakeholders, from the front-line clinician all the way up to the chief executive?   

• Are the analytics really meaningful?  Does the information help to make decisions?  Is it rich enough that we can really figure out why something is happening?

• Lastly, even if we have accomplished all these other goals, can we deliver the information in a timely fashion to the people who need this data to do their jobs?

Presenting Data – Referee Crew Calls in the NFL

One of the great things about computers is their ability to take tabular data and turn them into pictures that are easier to interpret. I’m always amazed when given the opportunity to show data as a picture, more people don’t jump at the chance.

For example, this piece on ESPN regarding the difference in officiating crews and their calls has some great data in it regarding how different officiating crews call games.

One thing I find a bit disconcerting is:

  1. One of the rows is missing data so that row looks ‘odd’ in the context of the story and makes it look like the writer missed a big thing … they didn’t (it’s since been fixed)
  2. This tabular format is just begging to be displayed as a picture.

Perhaps the issue here is that the author didn’t know how to best visualize the data to make his story, but I’m going to help him out.

If we start from the underlying premise that not all officiating crews call games in the same way, we want to see in what ways they differ.

The data below is a reproduction of the table from the article:

REFEREE DEF. OFFSIDE ENCROACH FALSE START NEUTRAL ZONE TOTAL
Triplette, Jeff 39 2 34 6 81
Anderson, Walt 12 2 39 10 63
Blakeman, Clete 13 2 41 7 63
Hussey, John 10 3 42 3 58
Cheffers, Cartlon 22 0 31 3 56
Corrente, Tony 14 1 31 8 54
Steratore, Gene 19 1 29 5 54
Torbert, Ronald 9 4 31 7 51
Allen, Brad 15 1 28 6 50
McAulay, Terry 10 4 23 12 49
Vinovich, Bill 8 7 29 5 49
Morelli, Peter 12 3 24 9 48
Boger, Jerome 11 3 27 6 47
Wrolstad, Craig 9 1 31 5 46
Hochuli, Ed 5 2 33 4 44
Coleman, Walt 9 2 25 4 40
Parry, John 7 5 20 6 38

The author points out:

Jeff Triplette’s crew has called a combined 81 such penalties — 18 more than the next-highest crew and more than twice the amount of two others

The author goes on to talk about his interview with Mike Pereira (who happens to be pimping promoting his new book).

While the table above is helpful it’s not an image that you can look at and ask, “Man, what the heck is going on?” There is a visceral aspect to it that says, something is wrong here … but I can’t really be sure about what it is.

Let’s sum up the defensive penalties (Defensive Offsides, Encroachment, and Neutral Zone Infractions) and see what the table looks like:

REFEREE DEF Total OFF Total TOTAL
Triplette, Jeff 47 34 81
Anderson, Walt 24 39 63
Blakeman, Clete 22 41 63
Hussey, John 16 42 58
Cheffers, Cartlon 25 31 56
Corrente, Tony 23 31 54
Steratore, Gene 25 29 54
Torbert, Ronald 20 31 51
Allen, Brad 22 28 50
McAulay, Terry 26 23 49
Vinovich, Bill 20 29 49
Morelli, Peter 24 24 48
Boger, Jerome 20 27 47
Wrolstad, Craig 15 31 46
Hochuli, Ed 11 33 44
Coleman, Walt 15 25 40
Parry, John 18 20 38

Now we can see what might actually be going on, but it’s still a bit hard for those visual people. If we take this data and then generate a scatter plot we might have a picture to show us the issue. Something like this:

The horizontal dashed blue lines represent the average defensive calls per crew while the vertical dashed blue line represents the average offensive calls per crew. The gray box represents the area containing plus/minus 2 standard deviations from the mean for both offensive and defensive penalty calls.

Notice anything? Yeah, me too. Jeff Triplette’s crew is so far out of range for defensive penalties it’s like they’re watching a different game, or reading from a different play book.

What I’d really like to be able to do is this same analysis but on a game by game basis. I don’t think this would really change the way that Jeff Triplette and his crew call games, but it may point out some other inconsistencies that are worth exploring.

Code for this project can be found on my GitHub Repo

Rogue One – A Star Wars Story

Rogue One – A Star Wars Movie: My Thoughts

Today I watched Rogue One and I wanted to jot down my thoughts while they were still fresh.

First, what I didn’t like:

  1. The Rogue One Font at the beginning on the movie. There was just something about it that wasn’t as strong as the Original Franchise
  2. The jumping around done at the beginning of the movie with the planet names (again, with a weak font).
  3. There were no Bonthans either dying or otherwise.

OK, not that’s out of the way. What did I like:

Every. Thing. Else.

Jin’s character had the depth needed to be a protagonist you would both believe and want to follow. I think the most surprising thing (maybe … I still need to think about this) is that from a writing perspective you know ALL of your characters are going to be throw away characters. They won’t appear in Episodes 4-6, although the actions they take drive those movies.

As I realized this, I realized that each lead character was going to die. It can’t really be any other way. And while I was sad to see that premonition come to fruition, I was also glad that the writers did what the story called for. Make the story a one-off whose characters can’t influence the canon in any way other then how they already had.

Maybe I went into the movie with low expectations, or maybe it was just that good. Either way, I would see this again and again and again.

The story was strong, with dynamic characters. A mix of good and bad for the rebels (as it should be) and all bad, but with depth for the imperial characters.

I liked this so much I have already pre-purchased it on iTunes.