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In my career, there have been a few perfect storms, defined as “a confluence, resulting in an event of unusual magnitude”.

When I was an undergraduate at Stanford University in 1980, two geeky guys named Jobs and Wozniak dropped by the Homebrew Computer Club to demonstrate a kit designed in their garage.   IBM introduced the Personal Computer and MSDOS 1.0.   I purchased an early copy of Microsoft Basic and began creating software in my dorm room including early versions of tax calculation software, an econometric modeling language, and electronic data interchange tools.   Every day brought a new opportunity. The energies of hundreds of entrepreneurs created an industry in a few intensely creative months that laid the foundation for the architecture and tools still in use today.   A guy named Gates offered me a job and I decided to stay in school instead.

In 2001 when I was first hired at Harvard, a visionary Dean for Medical Education, a supportive Dean of the Medical School,  talented new development staff, and a sleepless MD/Phd student came together to create one of the first Learning Management Systems in the country, Mycourses.   Robust web technologies, voice recognition, search engines, early mobile devices, and new multi-media streaming standards coincided with resources, strong governance, and a sense of urgency.  Magic happened and in a matter of months, an entire platform was created that is still powering the medical school today.

At BIDMC in 2010, IS Clinical Systems staff and key operational leaders realized that Meaningful Use Stage 1 was within reach if we temporarily put aside other work and focused our energy, creativity, and enthusiasm on rapid innovation, process change, and education.   In a few weeks we became the first hospital in the country to certify our EHR applications – inpatient and ambulatory.    We became the first hospital to achieve Meaningful Use.  More than 70% of our eligible professionals have surpassed meaningful use performance thresholds.   We had no budget, no dedicated resources, and nothing but strength of will to make it happen.   It was one of our finest hours.

In 2011, the Massachusetts public sector (Secretary of EOHHS, CIO of EOHHS), private sector healthcare leaders, and healthcare IT experts had a bold idea – create a public utility that links together all the existing regional health information exchanges, public health, small clinician offices, payers, and patients using modular components procured and initially operated by state government.   We aligned forces and in a few weeks created budgets, project plans, a new State Medicaid Health Plan, and a guiding coalition of stakeholders.    Political, organizational, and technical barriers were broken down and unbridled optimism rekindled our health information exchange momentum.    2012 will be a transformative year in the Commonwealth, truly a perfect storm.

My advice – look for the perfect storms in your own life.  Minimize your distractions, cancel unnecessary meetings, and put aside those tasks that don’t add value.   Take a risk and dive head first into the possibility of creating greatness.   I’ve seen opportunity come and go in my life.   No one remembers the mundane.  No one forgets the events of unusual magnitude.

Recently, I updated my BIDMC job description to include fostering healthcare information exchange among affiliates, accountable care organizations, and the community.   The Massachusetts Health Information Exchange is the next perfect storm in my career and I will devote all of my energies to the confluence being created by EOHHS CIO Manu Tandon, Massachusetts eHealth Collaborative CEO Micky Tripathi, and the dozens of volunteers lending the wisdom to the process.

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7 Responses for “The Perfect Storm For Innovation”

  1. John says:

    This blog entry, which is very inspirational, highlights the importance of innovation as a driving force of growth in the healthcare industry. While I agree with the entire discussion made here, I would like to underscore the need for government to facilitate a healthy business environment to spur innovation. Not only will this tighten the United States’ grasp on the cutting edge of medical technology but can also help secure job growth on the domestic front.

    And yet, in spite of the need to revamp the American economy, the proposed new taxes in medical device manufacturing/sales will move us in the opposite direction. Be sure to check out the link below to learn about the adoption of a new medical device tax, which penalizes American manufacturing and encourages foreign innovation.

    http://americanactionforum.org/topic/immensely-damaging-medical-device-excise-tax-gets-proposed-rule

    A perfect storm, which makes it friendlier for American companies to expand their businesses in the U.S, has still yet to develop.

  2. BobbyG says:

    “At BIDMC in 2010, IS Clinical Systems staff and key operational leaders realized that Meaningful Use Stage 1 was within reach if we temporarily put aside other work and focused our energy, creativity, and enthusiasm on rapid innovation, process change, and education. In a few weeks we became the first hospital in the country to certify our EHR applications – inpatient and ambulatory. We became the first hospital to achieve Meaningful Use. More than 70% of our eligible professionals have surpassed meaningful use performance thresholds. We had no budget, no dedicated resources, and nothing but strength of will to make it happen. It was one of our finest hours.

    In 2011, the Massachusetts public sector (Secretary of EOHHS, CIO of EOHHS), private sector healthcare leaders, and healthcare IT experts had a bold idea – create a public utility that links together all the existing regional health information exchanges, public health, small clinician offices, payers, and patients using modular components procured and initially operated by state government. We aligned forces and in a few weeks created budgets, project plans, a new State Medicaid Health Plan, and a guiding coalition of stakeholders. Political, organizational, and technical barriers were broken down and unbridled optimism rekindled our health information exchange momentum. 2012 will be a transformative year in the Commonwealth, truly a perfect storm.”
    __

    Yes!

    Our overpopulation of naysayers (whom medical economist JD Kleinke calls “policy tear-down artists”) needs to see this.

    O/T, John, I hope your wife is doing well.

  3. Peter1 says:

    Anybody out there smart enough to come up with an “innovation” on how to pay for healthcare?

    • sr says:

      I don’t think it’s a matter of intelligence, rather the ability to break down the stone wall of those who do not want such a solution. Over the years the answer I’ve gotten for why this hasn’t happened is almost always, “People like what they’ve got; people don’t want anything different.” Even, “Americans like to spend money on healthcare.” Too many people with too much to lose, and the general population not informed enough to know that it could be much better at much lower cost. Maybe it’s finding someone smart enough to be persuasive of all the “stakeholders”, as they say. (I hate that word!)

  4. BobbyG says:

    See Kleinke, 2005

    http://regionalextensioncenter.blogspot.com/2011/06/use-case.html

    Nothing much has changed.

    “The first step in understanding the real intractability of the problem is ignoring the rhetoric. There is a veritable cottage industry involving the articulation of moral outrage over the health care quality “crisis,” much of it public relations spadework for someone’s political or commercial ambition and most of it culminating in a the naïve insistence that the system is on the verge of collapse and cannot go on like this. Actually, it can and will go on like this forever, absent any major intervention by the nation’s largest health care purchaser—the U.S. government. “

  5. southern doc says:

    ” put aside those tasks that don’t add value”

    Like Meaningful Use Stage 1?

  6. Chris says:

    Great blog post. I feel as you do that it is about breaking down the walls built by those who don’t want a solution. I work for a software vendor (full disclosure) and many of the HIT vendors are part of the problem. I couldn’t agree more that it could be much better at much lower cost if we’re willing to consider the disruptive changes that are necessary to get there.

    Healthcare reform is an attempt to get to the right place, but as with most things mandated, they aren’t implemented in efficient fashion and often miss the point of the exercise. That’s what’s currently happening with Electronic Health Records. Vendors sell systems that capture and hold data instead of capturing data and serving it up to be available for key decisions as a patient’s treatment unfolds.

    We’ve made some things electronic but in the process have created new silos that can be only a bit better than paper.

    As you said, it is time to focus our energy, creativity, and enthusiasm on rapid innovation, process change, and education. It starts with ‘meaningful’ Meaningful Use and doesn’t end with system implementation. Mobile, Social, Big Data are all moving faster than healthcare IT reform. Until that changes, reform will be elusive.

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