Category Archives: Uncategorized

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.

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

The Internet? Bah!

Check out this hilarious 1995 Newsweek article by Clifford Stoll entitled The Internet? Bah!. Boy did he guess wrong. My favorite excerpt (my comments are in bold):

Then there’s cyberbusiness. What is cyberbusiness? We’re promised instant catalog shopping–just point and click for great deals. We’ll order airline tickets over the network, make restaurant reservations and negotiate sales contracts. Stores will become obselete. Right. So how come my local mall does more business in an afternoon than the entire Internet handles in a month? Malls are going bankrupt all over the country. Even if there were a trustworthy way to send money over the Internet–which there isn’t–the network is missing a most essential ingredient of capitalism: salespeople. Economists have been wrong this whole time, salespeople are the key to capitalism, not competitive free markets!

Enjoy!

Health IT Update – Feb 22

1. Health IT in Developing Countries – a 9-yr history and its future – open to all Harvard community members as part of the Harvard Kennedy
School of Government lunch seminar

2. Global Health Technologies Coalition: Advancing Innovation to Save Lives – useful website with lots of information on technology innovation – http://www.ghtcoalition.org

3. MIT Sloan Bioinnovations Conference – March 12 – see event details below…

4. PHAT/Health Underground Networking Event w/ AthenaHealth’s Jonathan Bush – April 1 (website coming soon)

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Save the Date!
MIT Sloan BioInnovations 2010 Conference: The New Age of Opportunity
http://web.mit.edu/bbc/bioinnovations/2010/

Friday, March 12, 2010
9:00 AM – 4:00 PM
Boston Marriott Cambridge (next to Kendall Square T-stop)

Register before March 1 for Early-Bird Discounts:
http://www.acteva.com/booking.cfm?bevaid=197535

Keynote Speakers:

Peter Wirth, Esquire
Executive Vice President, Genzyme Corporation

Dr. Robert Langer
M.I.T. David H. Koch Institute Professor

Matthew W. Emmens
Chairman, CEO, and President, Vertex Pharmaceuticals

Panels:

Healthcare Reform
Emerging Markets
Bringing Innovation to Market
Connected Healthcare

BioInnovations is a premier gathering of nearly 300 healthcare pioneers from a broad range of industries; from bio-pharma and medical devices to healthcare providers and non-profits.

Health IT Update – Feb 4, 2010

1. Today: Free Public Forum on HIT National Policy with David Blumenthal – Thursday, 8am-noon (www.hitpublicforum.com)

The Public Form on HIT National Policy is hosting a free conference this morning (it is starting right now!) with a great lineup of speakers, including David Blumenthal, the National Coordinator for Health IT, Marc Overhage, Director of Med Informatics at Regenstrief Institute, Aneesh Chopra, US Chief Technology Officer at the White House, and several others. Registration is free and the entire event will be webcasted. Blumenthal speaks from 9-9:30am. Content will be available online for 6 months…

2. Free OpenMRS Developer Training Week starting Feb 8

The Regenstrief Institute at Indiana University, the developers of OpenMRS, the popular open-source medical record system, are hosting a free week-long training session at IU beginning Monday, Feb 8. Most of the event will be webcasted. For more details: http://openmrs.org/wiki/OpenMRS_Developer_Training_Week_8-February-2010

3. Health Affairs February Issue on e-Health in the Developing World

This month’s Health Affairs issue is focused on e-health in the developing world, and includes articles on “An Agenda For Action On Global E-Health”, “e-Health Technologies Show Promise in Developing Countries”, and others on cell phones, EMR, informatics, and more.

http://content.healthaffairs.org/content/vol29/issue2/