Exceptional Experiences at Community Health Network

I was reading the latest issue of Entertainment Weekly and there was an article called “Oscars: Your Burning Questions Answered!“  One of the questions was what the word chuffed meant.  Colin Farrell said it introducing another star.  I was surprised that this question was in there because I knew the meaning of the word and have heard it frequently.

Then I realized that I knew what it meant because I am an anglophile and watch a lot of British television.  Also, it occurred to me that I have had a similar experience in talking with my family doctors who sometimes seem to be speaking a different language.  The trick is to share complex medical concepts and terminology in a way the a layperson can understand.  I have found myself doing this with technology terms.  A layperson can understand information technology concepts if they are explained in a non-technical manner.

I hope that our consumer health library explains complex medical concepts in a layperson’s terms.  I believe that it does but since I work in health care, I know that I’m not the typical user.

The past few days I have submitted my blog to Yahoo, Google and Technorati.  I haven’t appeared in Yahoo or Google yet, but I just submitted to the Google Blog Search today.  It should be indexed soon I think.

I was extremely impressed with Technorati.  When I submitted by blog it was instantly indexed (or so it seemed) and ranked.  My authority ranking instantly went up to 8.  I have an ranking of 8!  I liked that Technorati immediately visited my blog and indexed it.  My expectation was that it would be indexed in a week or two, the expectation set by Yahoo and Google.

Forget Google.  Howard Waldrop is the original mash-up artist.  And has been for thirty years.

Waldrop is considered a science fiction writer.  He frequently writes alternate history stories including one in which Eisenhower and Elvis had each other’s careers (”Ike at the Mike”) and another one where the last dodo is tracked down only to discover that it was eaten by a family in the south (”The Ugly Chickens”).  He brings together characters and events in an usual fashion.  “God’s Hooks” is about John Walton meeting John Bunyan and fishing for the Leviathan from Bunyan’s writing (obscure English Lit reference alert!).  He wrote a story about The Marx Brothers and Laurel and Hardy (”Save a Place in the Lifeboat for Me”) and one with Mickey Mouse, Goofy and Donald Duck robots (”Heirs of the Perisphere”).

One of my favorites is “Night of the Cooters” which stars a character who is an homage to Slim Pickens who battles the martians from “The War of the Worlds.”

Oh and the title of this entry comes from “Thirty Minutes Over Broadway.”

Bet you can’t wait to see my post on Philip K. Dick and the metaphysics of HTML code.

There is a spectrum of physician readiness regarding Internet technology acceptance. Some influencing factors include; physician’s work and home access, perceived quality of usability, the amount of the individual physician’s browser and email experience. Physician engagement in the use of technology has been a very staged and gradual process. It has taken some 8+ years (in our organization) to accomplish the current primary care adoption rate of the EMR (> 70% of total), portal and email usage (don’t have definitive measures on these yet). We see ourselves as progressive, but relatively early in our physician e-culture journey. Within this spectrum there are physicians of all ages who embrace technology and are willing to expend the energy to learn “how to” get stuff done. Others, do not have the tolerance, or are at a point in their professional working lives that they do not desire to expend such time on transitioning their respective work flow and clinical practice. That is by the way a key phrase to focus upon “work flow!”

Key learnings regarding physician web based technology engagement:

• Influential peers make a difference
• Measurable, improved clinical outcomes speak volumes
• Financial incentives can play a part
• Reproducible time effectiveness drives change
• Motivated, enthusiastic office staff essential
• Temporary, focused, additional support resources a must
• Effective governance structure must be in place to achieve large numbers

Physicians highly value physician to physician, face to face communication time. As is the case with the rest of the 21st century world there is gradual decrease in real time, much less face to face communication. Physicians don’t come to the hospital for professional social networking the way they used to. They still want and need data and information. They have more mechanisms to access it within an increasingly compressed time cycle to manage it.  The question at hand is “what is going to drive physicians to physician specific, secure portal/intranet or a corporate email account?” A text book answer might read like “more convenient connectivity to each other to clinical systems, more efficient workflow, CME, rapid access to reference material & to pose clinical questions / care plans / protocols / evidence based data.”

The content / data we all desire to share can be broadly categorized into the categories of communication/news, relationships/political, business operations and clinical operations. These diverse categories make physician intranet / portal and email adoption challenging but, it also (we believe) holds the secret to success.  Our experience to date regarding the adoption of electronic medical record (EMR) or corporate email would indicate that a one solution approach will not be quickly accepted by the majority. There is no magic solution that will remedy all physician e-culture challenges. Progress will be achieved through an evolution of education, experience and acceptance.  Ong and Polkowski et.al. 2001 writes that “It is possible to create and diffuse an Intranet in a multi-hospital system in a cost-effective manner. However, the key challenges were selling the potential of this new technology to opinion leaders and other stakeholders….”

This is an admittedly incomplete list of topic related articles, and I will promise to continue to add to this list as we may find relevant.

Online Physician Communications Related References

Medical intranet success factors
Healthcare Financial Management,  July, 1998 by Edward Fotsch
Obtained from the World Wide Web June 9, 2007
http://findarticles.com/p/articles/mi_m3257/is_n7_v52/ai_21045765

Medical intranets: new technologies expose old problems
Healthcare Financial Management,  March, 1998 by Edward Fotsch
Obtained from the World Wide Web June 9, 2007
http://findarticles.com/p/articles/mi_m3257/is_n3_v52/ai_20633688

Intranet Dashboard a Lifesaver for Sentara Physicians, March 16, 2007
Obtained from the World Wide Web June 9, 2007
http://www.intranetjournal.com/articles/200703/ij_03_16_07a.html

Building and Growing a Hospital Intranet: A Case Study
Kenneth R Ong, 1 Michelle Polkowski, Geoff McLemore, Mark Greaker, and Malcolm Murray, Kenneth R Ong
Obtained from the World Wide Web June 9, 2007 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1761884

The portal advantage. Hospitals lure docs with easy access to medical records
Greene J., Hospitals & Health Networks / AHA [Hosp Health Netw] 2001 Oct; Vol. 75 (10) pp. 56-8