Read any Non-Fiction in (close to) an Hour

This morning, I read the entirety of Keith Ferrazzi’s Never Eat Alone in 77 minutes and got more out of it than I have spending days reading equally informed books cover to cover. I did this using a really simple technique my Dad taught me but I never bothered to try until now.

I finished my master’s degree program last week and decided to tackle the mountain of books I accumulated over the last 2 years. The opportunity cost of carefully reading 50+ books is way too high, so the time came to experiment.

Here is the technique (order is important):

  1. Look through the table of contents to frame the book’s contents
  2. Skim the last chapter
  3. Skim the first chapter
  4. In reverse order, read the chapter title, the last paragraph followed by the first paragraph of each chapter, taking brief notes of important points (with page numbers), action items, and questions. Make note of chapters you want to cover in more detail.
  5. Skim chapters that you want to cover in more detail. Go through the chapter in reverse order, 1 page at a time, taking notes as appropriate.

When you are finished, you should end up with a page or two of critical points with references for you to go back to at a later date, action items and questions for you to follow up on. All this should take roughly one hour. This method works because most non-fiction books follow a prescribed format of state, describe, and restate. You miss some of the details, but you generally don’t retain these details anyways. This way, you only go back to read details that are important.

For a sample, check out the notes I took from Never Eat Alone (I took 3 pages, but it really should be shorter). Highlighted items are my action items or follow-up questions.

Let me know if you have other clever methods for getting all you can out of a non-fiction book in the shortest amount of time possible.

Global PHAT 2010 Videos Online!

All the videos and presentations from Global PHAT 2010 have now been posted in the online resources at http://www.globalphat.com. This includes presentations on ICT Failures, Effective EMR, and mHealth Solutions for Community Health Workers by:

  • Hamish Fraser, Director of Informatics & Telemedicine, Partners in Health
  • Mike McKay, Former Country Director, Baobab Health Malawi
  • Bobby Jefferson, Senior Health Informatics Advisor, Futures Group
  • Jonathan Jackson, Co-Founder, President, CEO, Dimagi
  • Josh Nesbit, Co-Founder & Executive Director, Frontline SMS
  • Donald Yansen, Chief Operating Officer & Co-Founder, ClickDiagnostics
  • Alvin Marcelo, Director, National Telehealth Center, University of the Philippines, Manila
  • Jessica Haberer, Harvard Initiative for Global Health

In addition, PHAT has partnered with GHDonline.org, an online platform of communities developed by the Global Health Delivery Project, to provide a forum for continuing the dialogue about the topics discussed at the event. I have just posted the content from the session titled Effective EMR: Moving Beyond the Technology, along with discussion questions in the GHDonline.org Health IT Community. You can access the discussion here: What non-technological factors make EMR effective?. If you are not already a member of GHDonline.org, I encourage you to join! It is a fantastic resource for engaging others with similar interests across the globe.

A Fresh Idea from Baobab Health: The Proactive Help Desk

I had the opportunity to meet with Mike McKay, the former country director for Baobab Health (www.baobabhealth.org) in Malawi. Mike built a team of Malawian software developers from the ground up to design a touch-screen patient registration system used in HIV clinics. The system is so intuitive that a janitor, who overlooked as a team of nurses was being trained to use the system, took over during the nurses’ lunch break and has since become a full-time patient registration clerk. He has now personally registered several hundred thousand patient visits. Take a look at this 1-min video to see the system in action: http://www.youtube.com/watch?v=cf49zRxhKhc.

One of the processes that Baobab uses to support sites after implementing the Baobab system is the “Proactive Help Desk,” in which the help desk calls each site at least once per week to ask if they have any questions, are any systems not functioning, or any problems. They do this in addition to being available for normal help desk requests.

This incredibly simple idea of the Proactive Help Desk is one of the most obvious ways I’ve heard of to create a useful feedback loop between system administrators and users, yet I’ve never heard of it before! By giving their users the opportunity to provide weekly feedback on the Baobab system, on the workflows, and on their particular context, they dramatically improve their ability to support users and to iterate the system and related processes to addresses immediate user needs.

HHS Just Announced Beacon Awards of $220 million

Surprised not to see Massachusetts on the list, but exciting nonetheless… Here they are:

Community Services Council of Tulsa, Tulsa, Okla. – $12,043,948

Leverage broad community partnerships with hospitals, providers, payers, and government agencies  to expand a community-wide care coordination system, which will increase appropriate referrals for cancer screenings, decrease unnecessary specialist visits and (with telemedicine) increase access to care for patients with diabetes.

Delta Health Alliance, Inc., Stoneville, Miss. – $14,666,156

Focus on achieving improvements for diabetic patients by electronically linking isolated systems and practices for care management, medication therapy management and patient education.

Eastern Maine Healthcare Systems, Brewer Maine – $12,749,740.

Expand community connectivity, including long-term care, primary care and specialist providers, to existing Health Information Exchange and promote the use of telemedicine and patient self-management in order to improve care for elderly patients and individuals needing long-term or home care.

Geisinger Clinic, Danville, Pa. – $16,069,110

Enhance care for patients with pulmonary disease and congestive heart failure by creating a community-wide medical home, promoting Health Information Exchange and extending Geisinger’s proven model for practice redesign  to independent healthcare organizations throughout region.

HealthInsight, Salt Lake City, Utah – $15,790,181

Improve Diabetes management performance measures by increasing availability, accuracy and transparency of quality reporting, leverage Intermountain Healthcare’s strategies to reduce health systems costs throughout the region, and improve public health reporting.

Indiana Health Information Exchange, INC., Indianapolis, Ind. – $16,008,431

Expand the country’s largest Health Information Exchange to new community providers in order to improve cholesterol and blood sugar control for diabetic patients and reduce preventable re-admissions through telemonitoring of high risk chronic disease patients after hospital discharge.

Inland Northwest Health Services, Spokane, Wash. – $15,702,479

Focus on increasing preventive services for diabetic patients in rural areas by extending Health Information Exchange and establishing anchor institutions in close proximity to remote clinics that will promulgate successes in health IT supported care coordination.

Louisiana Public Health Institute, New Orleans, La. – $13,525,434

Reduce racial health disparities and improve control of diabetes and smoking cessation rates by linking technically isolated health systems, providers, and hospitals; and empower patients by increasing their access to Personal Health Records.

Mayo Clinic Rochester, d/b/a Mayo Clinic College of Medicine, Rochester, Minn. - $12,284,770

Enhance patient management and, reduce costs associated with hospitalization and emergency services for patients with diabetes and childhood asthma and address reduce health disparities for underserved populations and rural communities.

Rocky Mountain Health Maintenance Organization, Grand Junction, Colo. – $11, 878, 279

Enable robust collection of clinical data from health systems, providers, and hospitals in order to inform practice redesign to improve blood pressure control in patients with diabetes and hypertension, increase smoking cessation counseling, and reduce unnecessary emergency department utilization and hospital re-admissions.

Southern Piedmont Community Care Plan, Inc., Concord, N.C. – $15,907,622

Improve care coordination for patients with diabetes, heart disease, hypertension, and asthma by engaging patients and providers in bidirectional data sharing through a Health Record Bank, empowering patients and family members to participate in self-management through patient portals, and expanding access to care managers to facilitate post-discharge planning.

The Regents of the University of California, San Diego, San Diego, Calif. – $15,275,115

Expand pre-hospital emergency field care and electronic information transmission to improve outcomes for cardiovascular and cerebrovascular disease, empower patients to engage in their own health management through web portal and cellular telephone technology, and improve continuity of care for veterans and military personnel through the Veterans Affairs/Department of Defense Virtual Lifetime Electronic Record initiative.

University of Hawaii at Hilo, Hilo, Hawaii – $16,091, 390

Implement a region-wide Health Information Exchange and Patient Health Record solution and utilize secure, internet-based care coordination and tele-monitoring tools to increase access to specialty care for patients with chronic diseases such as diabetes, hypertension, and obesity in this rural, health-professional shortage area .

Western New York Clinical Information Exchange, Inc., Buffalo, N.Y. – $16,092,485

Utilize clinical decision support tools such as registries and point-of-care alerts and reminders and innovative telemedicine solutions to improve primary and specialty care for diabetic patients, decrease preventable emergency room visits, hospitalizations and re-admissions for patients with diabetes and congestive heart failure or pneumonia, and improve immunization rates among diabetic patients.

Step 1 – Opposing Views of EMR’s Ability to Improve Care and a Possible Synthesis

The Argument In Favor of: Computerized electronic medical records (EMR) will improve quality of care. EMR facilitates streamlining administrative processes, reducing overhead. Accurate and quickly accessible patient health information is a prerequisite to timely, informed, patient-centered medical care. Numerous studies have shown that CPOE can reduce medication errors and adverse events as much as 99%, increasing safety and reducing costs.(1) The ability for practitioners to access the same record in real-time from multiple sites or to send a record electronically to another provider puts potentially life-saving information where it is needed most. Decision support systems built on top of EMRs can support care by managing clinical complexity, controlling cost by suggesting less expensive alternatives, catching drug-drug or drug-allergy interactions, and promoting best practices.(2) EMR can help empower patients by connecting them to tailored health education materials. Other information intensive industries spend approximately 10% of their budgets on IT whereas health spends only 3%. If the health sector spent similarly, it would be able to realize significant gains.

The Argument Against: Electronic medical records rarely improve medical care and can even make it worse. Jeffrey Linder et al found that there was no association with presence of EMR and quality for 17 different measures, and this has been confirmed by other studies.(3) Providers who have experienced gains are generally academic medical centers whose results are not reproducible outside of that setting. In one example, Children’s Hospital of Pittsburgh rolled back a multi-million dollar CPOE implementation in the pediatric ICU after it was discovered that mortality had increased. Physician productivity can drop as much as 20% for the first 6 months after EMR implementation. A good ROI has generally only been obtained by large, integrated networks through savings on administrative overhead. Until technology systems mature and implementation processes improved, resources would be better invested elsewhere.

A Potential Synthesis: Electronic medical records are an enabling technology that supports cost-savings and quality improvement processes only if meaningfully and effectively used. David Cutler maintains that other industries required ten years to realize industry-wide gains from the use of information technology. The health sector started using IT later than other industries, but will be able to realize significant gains after clinical workflows and local cultures adapt. EMR data enables providers to do monitoring and evaluation and quality improvement that would not be possible otherwise, but business processes must be modified to take advantage of them. Providers should first implement technologies and features that have proven to be effective, such as CPOE, automated prescribing and dispensation. National “meaningful use” regulations, while imperfect and politicized, help guide physicians, health system planners and vendors on methods to increasingly leverage technology to improve health.

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1. Koppel, JAMA 2005; Bates, 1998; Pestotnik 1996.
2. Perreault L, Metzger J. A pragmatic framework for understanding clinical decision support. Journal of Healthcare Information Management. 1999;13(2):5-21.
3. Jeffrey A. Linder, MD, MPH; Jun Ma, MD, RD, PhD; David W. Bates, MD, MSc; Blackford Middleton, MD, MPH, MSc; Randall S. Stafford, MD, PhD. Electronic Health Record Use and the Quality of Ambulatory Care in the United States. Arch Intern Med. 2007;167(13):1400-1405.

Harvard Global Public Health & Technology Conf – May 1, 2010

Moving Beyond the Technology

www.globalphat.com

When: Saturday, May 1, 2010
Time: 8am – 7pm
Where: Harvard Kennedy School (HKS), 79 John F. Kennedy Street
Cost: $50 Standard Registration ($20 Full-Time Student)
Information and communications technologies (ICTs) have the potential to transform health delivery throughout the world, whether through the use of electronic health records to manage HIV/AIDS care in rural Uganda or mobile devices providing community health workers with decision support  in the field. Too often, however, this potential is not realized because undue emphasis is placed on the health technology in isolation, not in context.

Global PHAT 2010: Moving Beyond the Technology puts the health technology in context, focusing on human-centered, practical implementation strategies in developing country settings. This one day event brings together health technology implementers to examine the critical factors that make cutting edge technologies successful, including capacity building, partnership development, monitoring and evaluation, workflow and information flow optimization, and cultural contexts.

CLICK HERE TO REGISTER – SPECIAL RATES APPLY FOR HARVARD STUDENTS!!

Confirmed Panel Sessions

  • Health Information Technology (HIT) Failures
  • Effective Electronic Medical Records (EMR) – Moving Beyond the Technology
  • Survey of Selected HIV Information Systems
  • Role of Technology in Disaster Response
  • Mobile Health (mHealth) for Community Health Worker (CHW) Programs: Implementation Insights

Confirmed Speakers – Just Announced!

  • Dr. Hamish Fraser, Director of Informatics and Telemedicine, Partners in Health (PIH)
  • Mike McKay, Former Country Director, Baobab Health, Malawi
  • Jonathan Jackson, Co-Founder and CEO, Dimagi
  • Josh Nesbit, Co-Founder and Executive Director, FrontlineSMS
  • Dr. Alvin B. Marcelo, Director of the University of Philippines National Telehealth Center
  • Prabhjot Dhadialla, Program Director for Health Systems, Development, and Research, Earth Institute, Columbia University
  • Dr. Leo Anthony Celi, Founder, Moca

Health IT Update – 3/24/2010

1. Networking Event with Jonathan Bush – April 1, 6-8pm @ HBS, Williams Room – RSVP Required

2. Massachusett’s Governor’s National HIT Conference – Health IT: Saving Lives, Reducing Costs & Creating Jobs – April 29-30 (http://mahealthdata.org/Events?eventId=131818&EventViewMode=EventDetails)

3. ONC Releases White Paper on Consumer Consent Options for Electronic Health Information Exchange

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1. Networking Event with Jonathan Bush – April 1, 6-8pm @ HBS, Williams Room – RSVP Required

RSVP Required: hit.networking.2010@gmail.com (Include name and organization). Space is limited so reserve your spot quickly!

PHAT and the Health Underground, Boston’s new multi-disciplinary forum for graduate students interested in health IT, invite you to an evening of conversation and networking with Jonathan Bush, CEO of AthenaHealth, on April 1 at the Harvard Business School. Mr. Bush will be sharing the AthenaHealth story and his vision for the future of health IT. Light snacks and drinks provided.

Thursday, April 1, 6-8pm, Williams Room, Harvard Business School

Jonathan Bush, CEO, President and Chairman, AthenaHealth - Jonathan Bush is athenahealth’s Chief Executive Officer, President and Chairman. Mr. Bush co-founded athenahealth in 1997. Prior to joining athenahealth, Mr. Bush served as an EMT for the City of New Orleans, was trained as a medic in the U.S. Army, and worked as a management consultant with Booz Allen & Hamilton. Mr. Bush obtained a Bachelor of Arts in the College of Social Studies from Wesleyan University and an M.B.A. from Harvard Business School.

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2. Massachusett’s Governor’s National HIT Conference – Health IT: Saving Lives, Reducing Costs & Creating Jobs – April 29-30 (http://mahealthdata.org/Events?eventId=131818&EventViewMode=EventDetails)

Registration for full-time students is only $150!

This is a one-of-a-kind event which will bring together state leaders such as:

  • Governors,
  • Secretaries of Health and Human Services,
  • Medicaid Commissioners,
  • HIT Coordinators, and
  • key state legislators

along with federal officials and the Massachusetts healthcare community to discuss how we can successfully implement health information technology and health information exchange.

You don’t want to miss the opportunity to hear the remarks from federal and state leaders and to meet and network with people from around the country that are addressing the challenges of HIT policy development and implementation. The program will be held at the Westin Waterfront Hotel, conveniently located near Logan Airport and downtown Boston.

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3. ONC Releases White Paper on Consumer Consent Options for Electronic Health Information Exchange

The whitepaper examines issues regarding whether, to what extent, and how individuals should have the ability to exercise control over their health information in an electronic health information exchange environment.  It looks at existing approaches and details policy options, considerations, and analysis.  This whitepaper will serve as input to, and be reviewed by, the HIT Policy Committee’s Privacy and Security Workgroup as it prepares to make recommendations related to consumer consent in an electronic health information exchange environment.  The whitepaper is the first in a series of privacy and security reports developed by George Washington University under contract with ONC.

The whitepaper can be downloaded at http://healthit.hhs.gov/portal/server.pt?open=512&objID=1147&parentname=CommunityPage&parentid=32&mode=2&in_hi_userid=11113&cached=true