Curbside Consult with Dr. Jayne 7/27/20

I’m not sure if I ever thought I’d reach this point, but today marks my 1,000^th post for HIStalk. I should have hit it earlier in the year, but without daily posts from HIMSS it took a little longer than anticipated. I’ve been struggling with what to write about, since I felt like it should be something with gravitas for a momentous occasion. I don’t think any of us thought we’d be in the middle of a global pandemic this year, and that our industry would be going through all kinds of changes as the world’s healthcare system is pushed to the breaking point. After floating in the neighbor’s pool for a couple of hours, which is marvelous for achieving clarity, I decided to do a little tour down memory lane.

My first post appeared on January 8, 2011, when we were deep in the world of Meaningful Use. Browsing through my first few months of writing, I came across a quote that certainly applies to 2020. “The life of a CMIO is never dull; there’s always a fire to be put out somewhere, and usually an angry physician behind the scenes holding a lit match.” Over the last nine and a half years, the physicians have become less angry about IT projects, but now they’re burned out and frustrated from the challenges of treating a brand-new and deadly virus in less than ideal circumstances. I don’t envy members of technology teams that have to try to deploy new solutions in this challenging new environment.

The next year brought such adventures as the transition to the HIPAA 5010 transaction standard and the beginning of Medicare allowing its claims database to be used for provider report cards. August 2012 brought the passing of astronaut Neil Armstrong, and I had a few things to say about his passing that still ring true today:

His death was marked in a way that matched the way he lived – quietly and with little fanfare. By commanding the Apollo 11 mission and being the first person to walk on the moon he had earned the right to be celebrated. The amazing part of his story however is what happened after July 20, 1969. He didn’t dance in the end zone or become tabloid fodder. He went back to work and back to his roots. I’m touched by a quote from an article marking his passing. In an interview in February 2000 he said:

I am, and ever will be, a white socks, pocket protector, nerdy engineer. And I take a substantial amount of pride in the accomplishments of my profession.

We should all take a substantial amount of pride in the accomplishments of his profession. Not to take anything away from the astronauts, but I’m talking about the engineers. NASA’s steely eyed missile men sent people to the moon using chalk boards and slide rules. They didn’t have anywhere near the technology that most of us carry in our pockets today, but they changed the world.

Those of us working in health care IT today are up to our eyeballs in technology. It feels like things are moving so fast we will never catch up. As hospital leaders we are challenged to deploy the latest “thing” regardless of quality or outcomes. I have many friends in the medical software industry ranging from developers to CEOs. The aggregate of their skills and creativity could propel us into a new era of patient care. Instead we seem mired between the twin terrors of governmental compliance and simply improving yesterday’s products. I want to see the software equivalent of the space race where vendors are competing for the best designers and engineers and working to deliver a superior product.

Rather than the challenge of getting a man to the moon and returning him safely, the goal should be to deliver patients safely through the health care experience while we collect all the telemetry data needed to make the next trip with even better safety and quality. Another challenge – it’s easy to forget that as broken as our health care delivery system is, it is still better than what is available in some parts of the world. Let’s figure out how to make those leaps for all mankind.

It really got me thinking about whether we’ve really made the great leaps we could have been making over the last eight years. Although there are some nimble companies innovating, from the physician end-user perspective, it feels like we’re still dealing with marginal improvements on older products. The exam room of the future has not yet come to pass for the more than a handful of physicians, and although we can ask Alexa for the weather forecast, we certainly can’t ask her to predict when we’ll actually see the results of the COVID swab we just ordered. We’ve had a substantial missed opportunity as far as improving the lives of our end users, who have largely slipped into the mode of learned helplessness.

Thumbing through posts from around Thanksgiving in that year, I had a moment of sadness as I read “Dr. Jayne’s Holiday Recipe Guide.” I think it’s safe to say that the days of the office potluck are over for the foreseeable future. I treasure those times spent with my team as well as the delicacies shared – whether it was Bianca Biller with her “Hot Bacon Dip” or Paul the Intern with his “Crave Case” of White Castle hamburgers, there was always a variety of interesting things to eat and a lot of laughter.

Don’t get me wrong, things can still be fun and relationships can be built in the virtual world, they’re just different. In a world built around virtual meetings, I certainly wouldn’t have been able to clink glasses with both Jonathan Bush and Judy Faulkner within 10 minutes of each other (thank you, HIStalkapalooza 2013). There’s something about the bonding that happens when you stroll the HIMSS exhibit hall with a friend (especially one wearing a beauty queen sash that he won the night before), whether you’re trying to do serious work or just making fun of the insanity that is our industry. There’s also something about trying to get your shoulder back into its socket after dancing with Matthew Holt, but that’s another story for another day. Perhaps one day we’ll be able to do those things in-person again, and when we do, I’ll have the sassy shoes I purchased for HIMSS20 at the ready.

To my readers, thank you for being part of my world for the last 1,000 posts. I hope that each of you is able to stay safe, healthy, and sane during the great dumpster fire that is 2020. Whether you’re on the clinical front lines or in a supporting role, I appreciate your contributions to the care of patients around the world. The practice of medicine would be substantively different without everyone in the healthcare IT family. And so, I raise my virtual martini glass to each of you – here’s to the next 1,000 posts, and to better times ahead.

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