When I saw this post on the great Bad Banana Blog- a site who’s fantastically witty Twitter profile beguiles the design and art oriented site and makes one wonder if they are even connected – I was struck by a thought:

Give me the means to build my dream and I will

Looking at these images, there is not much practical value to the design of the Hergé Museme. I mean that in the truest definition of practicality, a crooked staircase is not the easiest to climb. Although, even given my green interest in design and architecture, I appreciate the art involved. There is something to Christian de Portzamparc who designed Hergé. Someone, maybe many people, gave de Portzamparc enough latitude, trust, money and faith to build his vision (and honor Hergé).

What would you do with enough latitude, trust, money and faith to build your vision? Do you have a dream that you could articulate and bring to fruition?

In the traditional sense most of us, and the same was probably true for Christian de Portzamparc, will need to prove ourselves over a series of small, incremental steps. To propose a radical idea, no matter how committed you are to it, is a risky thing. I love imagining both the confident creative “ah-ha” that de Portzamparc must have experienced juxtaposed against the frightful, risk that came with presenting this design.

I’m inspired by this building, its impracticality and its existence. It is someone’s vision and to bring a vision this unique to reality deserves applause in itself. What great ideas go unfulfilled because someone doesn’t present them, or worse, someone else is unreceptive? How many great things are built as the result of taking a chance on something seemingly risky?

See the rest on Bad Banana

The VA pretty much invented travel medicine

The VA system is divided into “21 regions called Veterans Integrated Services Networks (VISN). Each VISN is responsible for coordination and oversight of all administrative and clinical activities within its specified region of the country.” –Va.gov

Put practically, each region features clinics and hospitals that do different things. For instance, here in Richmond Virginia the McGuire VA Hospital is a center of excellence for brain trauma and ploytrauma. The Minneapolis VA Medical Center specializes in orthopedics and women’s care. There is overlap, many VA medical centers all do the same common procedures. However, it comes to something major the VA has found it more advantageous to move patients to specific places. If a center on the west coast has the best oncology treatment program with the best outcomes, why not send patients there?

Here in the US we have begun to explore travel medicine more in the last few years. In June 2010, the Lowes hardware stores announced a partnership with the Cleveland Clinic for heart surgery.

There are clear benefits to patients as well. When providers specialize it is often around a cutting edge procedure or technique. For example, a mitral valve repair done with a surgical robot often has the patient out of the hospital in two days rather than the nine that most open heart patients spend. That same mitral valve patient is also back at work in a fraction of the time as someone who had their chest cracked open.

As medical technology and the skill set of providers advance, it may become increasingly challenging for every hospital to be all things to all people. And thats ok. Sure, every hospital should probably continue to deliver babies, set broken arms and remove a burst appendix. But does every hospital need to do knee replacements? It is a challenging question to ask ourselves, particularly in a time when reimbursement has more challenges than ever before. However, integrated systems are on the rise; multi-hospital systems may already starting to figure out what procedures work best at which facilities. Travel medicine could be a real boon for both outcomes and cost savings.

Employee Driven Innovation

In early 2010 the VA system launched a system-wide innovation campaign dubbed the Innovation Initiative. The Veterans Affairs team built a Digg-like website which allowed any employee to submit an idea for improving patient care. Other employees voted on the the idea by clicking a thumbs up icon. The more votes, the higher up the list the idea was placed.

The top 100 ideas were presented to senior leadership who are selecting the top 25 to enact.

It is a simple thing really – let the people who are caring for patients every day tell us how to do it better.

note: unfortunately the site is no longer available to the pubic

Last April, we were out in Vail on the first day of a week long trip. My dad and I separated from my mother and my wife to go ski outer Mongolia in some soft but quite nice spring snow. Since he had the video camera, I had him go first with the intention of rocking through the bumps and getting some ego footage. I had a great run and took my time coming to a stop at the relatively flat bottom. As I was coasting slowly I lost my balance, the back of my ski dug in to some lose snow and I went over like a slinky. I heard a pop, shouted some choice words and lay there in pain for at least 10 minutes.I managed to ski down the front side of Vail, mostly on one ski (thanks years of race training for that useful trick!).

(I documented a lot of that process here and tagged posts as ACL)
I had the reconstruction at home and this winter was back on the snow, skiing better than before the fall. It was a painful surgery and the rehab was hard – mostly because  it was boring and time consuming, not all together painful.
On the one year anniversary, to the day, of that fall we were out in Steamboat. Same story- the old man and I hitting the back bowls. On our way back to the front, we came upon The Boat’s section of double black diamonds. So I did the reasonable thing and sent my father ahead with the video camera. My thought was to get a video to send to my orthopedic doc to show him my full recovery. What would be a better testimonial than me flying down an impossably steep double black one year after my injury and reconstruction?

Right as I was taking off, Dire Straits’ Espresso Love came on my iPod. For the whole year, I had avoided listening to that song. It was playing when I went down last year! But I was in mid turn, and off to a nice start and decided to ignore it. I skied a fairly iced out steep pitch nicely, although not as gracefully as I would I have liked. I took a pause and came to a gliding stop and thats when it happened.

The same, exact fall. Right knee this time. Same pop, but not nearly as much pain and no loss of range of motion (no swelling)
I again skied off the mountain and even skied the rest of that week; followed by another two trips out west of some seriously hard skiing. In fact, I even bought two new pairs of skis this year because I was skiing so well. Unfortunately this right knee just has not changed. It is no worse, but no better either, there  is a constant dull pain. I’ve been in the gym pretty hard (squatting 360lbs often) and it feels stable when I run. Walking is another story, it does not totally slip out like my left did pre-surgery, but it locks up a bit with some significant pain at random times.

I broke down, had the MRI and consult. The diagnosis is a torn right ACL. Surgery seems imminent, and I am begining to make peace with that. My hope is, since I did not swell and do not have the resulting muscle loss, that I can do an abbreviated PT schedule and get back into the gym sooner. I’d rather not lose the ground on the weight loss and fitness while I convalesce for another 6 months.

So add this to the list of posts on this blog tagged with ACL… lets home this does not become an annual feature!

Most hospitals refer to themselves, internally, with initials. Some State Regional Hospital is probably SSRH internally. There’s a good chance you can register those initials or a close variant. It makes a nice way to keep your tweeted links aligned with your brand.

Bit.ly, and Bitly.pro also allow you to create custom short names. When you combine a custom domain and short name, some even neater things happen. Rather than saying “find us on facebook” you can use a link like ssrh.biz/ssrhfb . It makes a nice way to send links internally as well.

The waiting time for a bitly.pro invite seems to be less than a week. In addition to the custom domain, they also provide some enhanced, detailed reporting tools. Check it out at the Bitly.Pro site.

As for me, I’ll be posting links via Daws.in (because .on isn’t a valid suffix and I was all out clever).

Of the topics discussed, one that really resonates with me are some of the complications surrounding the reimbursement challenges of our third party payor system. For those of us who work in that part of the industry it can be easy to be lulled into forgetting how complicated the system is. Ask any patient who has been denied after seeing a doctor and they can remind you about the challenges.

The Interval crew also delved into a question posted on Health Leaders Media: “If You Could Tell the CEO One Thing About Marketing, What Would it Be?” My comment on that post was, “marketing is dead”. As ambiguous and inflammatory as that comment sounds, the Interval team did a great job of interpreting my meaning. One of my favorite concepts is the idea of the “experience economy”. The term comes right from the title of a book by Pine and  Glilmore. The essence is that we live in a time when ubiquitous connectivity and real time communication (IE social media) enable consumer to discuss products and experiences in real time. To put that in context, I do not need to see a billboard about a hospital in town, I can see what people are saying about that hospital right now online. Those experiences will have a much greater impact that marketing.

Chris makes an eloquent counter point about marketing. When applied as the “art and science  of [retaining and growing a customer base]” it is not far afield from the experience economy. I would argue that under that definition the onus (and effort) moves off of traditional marketing and is placed on operations, customer service and clinical outcomes. In that sense, the need for billboards and print ads becomes superfluous – marketing, at least in that sense, is dead.

I have had the recent pleasure of some deep conversations with a friend who knows a lot more about these concepts than I do. Without a doubt those who “get it” understand that the future of healthcare marketing is not about a bigger watermelon truck. Business development has to be strategic and tied to the proverbial bottom line. When service and the patient experience are approached with the same attention, the results are surprisingly affirmative in advancing that bottom line number.

Enough of my drivel, have a listen to Chris and the Interval team here on their site, or subscribe via iTunes

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Thanks to all those who participated:

• Dr. Jeff Livingston aka @macobgyn
• Christine Kraft  aka @christinekraft
• Dr. Val Jones aka @drval
  
• Jon Richman  aka @jonmrich
• Nick Dawson  aka @nickdawson
• Liza Sisler  aka @lizasisler
• Greg Matthews aka @chimoose

And a special thanks to the producers of the event:

• Meredith Gould aka @meredithgould
• Tom Stitt aka @tstitt

Finally, and to reiterate what I said at the top of my segment in the audio cast, thank you to the #HCSM community. In the last year we have laid the ground work that is changing the face of healthcare. Every day this group comes up with new ways to improve the patient experience. After all, we are all patients.

Our ability to chose for ourselves is one of the many things for which we have to be thankful . Last year,  bloggers reminded us that there may come a time when we, or someone we love, may not be able to make their own choices. It is a hard conversation to have, discussing end of life care, but remember that if we do not have it now, then when the time comes for our wishes to be known, it may be too late.

Engage With Grace is the “one slide project” that aims to inspire families and individuals to think about end of life care by answering 5 simple questions. It may be hard to discuss, but imagine how much harder it will be to face these decisions without knowing what your loved one would prefer. This Thanksgiving, take a few minutes with your friends and family and engage with grace.

]]> http://www.nickdawson.net/blog/ewg/feed/ 2 http://www.nickdawson.net/blog/breadcrumbs/ http://www.nickdawson.net/blog/breadcrumbs/#comments Thu, 29 Oct 2009 21:46:27 +0000 nick http://www.nickdawson.net/?p=563 I have been thinking a lot lately about the relative importance of social media. Actually, I have been thinking about history. Really, what we know about history is what was recorded by the people who thought those particular details were favorable or important. What’s the old saying? History is written by the victors. In a sense, the same thing is true for recent history; take family for example. What do we really know about what our parents were like in high school?  I am inclined to believe my parents were pretty cool cats. I have seen pictures of them before prom, football uniforms and signed yearbooks. But the truth is that I was not there. The truth is that I am seeing their history as told by the victors.

Now think about this – think about all the kids growing up in the socially networked generation. What happens when they grow up and have families of their own? Who gets to tell the history when it was already been documented live in real time? Its a mind-bender isn’t it? The children of the next generation, maybe even my kids, will have a digital history of our entire lives. Everything we posted, tweeted, flickred, youtubed, regretted, liked, friended, faned…. it will all be there. That embarrassing night in college, videos from our wedding, tweets about the first job. Imagine the internet as the scrapbook of the future. What will our kids find when they google us?

As I started thinking more about the idea – and indeed the importance of the concept itself – it made more sense (at least to my twisted brain) to explore it graphically:

To that end, you’ll probably enjoy this presentation in full screen here