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Occasionally I write something that seems worth sharing beyond it's primary audience.   Here are some pieces I thought you might enjoy...

National Managed Health Care Congress Presentation on the Ideal CIO - April 17, 2000, Atlanta, GA

I served on a panel discussion of experts for NMHCC this Spring.  Our topic:   What should you look for in a CIO?  With the market such as it is these days, I thought the best way to illustrate my thoughts would be to sit down and write a want ad...

Desperately Seeking CIO

The following advertisement was recently spotted in the New England Journal of Medicine...

Wanted:  CIO for a major not-for-profit academic medical institution with a prestigious history of providing world-class health care and conducting revolutionary medical research.  Must have advanced experience in information technology and computer science to be able to bring multiple legacy systems from seven recently merged competing institutions together into a single platform system – PhD from Stanford preferred.  Advanced understanding of medical terminology, procedures and processes required – MD from Harvard preferred.  Must have at least 10 years of project management experience and a proven track record for delivering final products on time, on spec and under budget – MBA from Wharton preferred.  Intimate knowledge of network security and cryptography to protect patient privacy required – experience as a CIA operative preferred.  Must be able to deftly navigate the ego-infested jungle of academia, kowtowing to back-stabbing physicians, inept administrators, and Nobel Prize-winning, prima-donna researchers who think of you more as “that IT guy” than a member of the institution’s senior management team – former Navy SEAL (or equivalent combat experience) preferred.  Must be able to explain to non-technical committee members who haven’t yet discovered the existence of the right mouse button the differences between the Internet, an intranet, an extranet, and a fishing net – communications degree from the Dale Carnegie Institute preferred.  Must be able to communicate equally well with 22-year-old, snot-nosed programmers with multiple body piercings who are probably only staying at their jobs in order to have access to the hospital’s network so that they can design the latest music piracy software, launch an IPO, and have an overnight market cap that is ten times larger than the hospital’s endowment – former MTV vee-jay (or equivalent band experience) preferred.  Must be able to convert a financially hemorrhaging institution with no clear business model or strategic plan into a virtual, web-enabled, dynamically outsourced, buzzword-compliant e-business without making any additional capital, infrastructure, or personnel expenditures - 7th-level Wizard (or prestidigitator with equivalent work experience) preferred.  Compensation package competitive with the stock options offered to the front desk clerk at  Women and minorities are encouraged to apply.   Serious inquiries only. 

For about a year and a half, I edited a newsletter for Aspen Publishers, Inc. and the Medical Group Management Association called Essential Informatics for Medical Groups.  One of my favorite parts of the job was to write a monthly editorial about information technology.  Here I could have some fun while making a point.  Below are a couple of my favorites.

Turning the corner on the information superhighway at Mach 1

Our modern world recently reached a great computer technology milestone. It wasn’t when a Fairchild microprocessor the size of a match head was programmed to deliver web pages over the Internet, making it the world’s smallest Web server. It wasn’t even when Sears and Chevron were bumped off the elite list of 30 blue-chip stocks used to calculate the Dow-Jones Industrial Average in favor of Microsoft and Intel.

No, the greatest milestone yet in the advance of information technology happened rather quietly last Thanksgiving weekend in the little city of Fairborn, Ohio.

My mother bought a computer.

I should say, more correctly, my mother grudgingly acquiesced to her family buying her a computer. She had deftly dodged the blessings of cyberspace for years, arguing that the technology was too expensive and too complicated.

Now, a word in defense of my mother -- she’s no Luddite. In fact, she has a fax machine, a simple, stand-alone word processor/printer, and Call Waiting. In her view, she could do everything she wanted using the tools she already had.

In the end, she was won over by that sinister force that besets many seniors – peer pressure. All of her friends were getting e-mails and pictures from their grandkids. But the final blow came when she lost her job reading letters to her Sunday school class from members traveling abroad because they were now being sent to the entire group (except her) via e-mail.

We chose the day after Thanksgiving as C-Day. I would be in town to set up the whole system and could spend quality time with the folks to bring them up to speed. Despite my valiant efforts, she just didn’t seem to be "getting it." I was losing hope; she was losing patience.

Many "customer support" calls followed. After a while, though, the calls came with less frequency. Then the other day, I sent her an e-mail with a picture attached. Moments later, a reply; she had opened the attachment and printed it out without a hitch. Angels sang.

Big deal, you say? Well, for the last few years I've been using the "mom test" when evaluating technology solutions. I can usually figure out most software on my own. But the true usability question is always, "Could my mom figure this out?" That's part one of the mom test.

Part two is, "Could my mom install this?" We're not there yet. But, while we have not yet reached the IT equivalent of warp speed, we have finally broken the sound barrier.

My mother, the computer user.

A new era has dawned. History books will recount the contents of her first e-mail – like Bell's immortal words when he called out for Watson. Children will sing songs in celebration of this great day. Politicians will invoke the spirit of the moment in stirring campaign speeches while "America, the Beautiful" plays in the background.

Or at least I will write a commentary about it.

© 1999 Ross D. Martin, MD, MHA

Adapted from the my editorial for the February 2000 issue of Essential Informatics for Medical Groups, co-published by Aspen Publishers, Inc. and the Medical Group Management Association.


Scenes from the next ER

An e-mail from a frantic yet resourceful father dropped into my inbox not long ago. His daughter's MRI films – the only copies – had been mailed from Kansas to a world-renowned specialist at our hospital for evaluation. They never reached their intended destination.

He had found my name on the Internet after doing a search for Brigham and Women's Hospital. He threw a Hail Mary pass to me, hoping that I would receive this stranger's plea for assistance and help him solve the mystery of the missing films – saving precious time and perhaps his daughter's life.

I did what legwork I could. I went down to the Radiology department and got in line with the residents and others at the front desk. Our hospital, recognized internationally for its innovation in information systems, still looked pretty much like every other hospital I had been in – with a very busy staff trying to process a mountain of information. We all stood around, waiting our turn, and accepting this nonsensical bottleneck as part of the medical landscape.

Ultimately, I was unsuccessful. The department had no records or films matching the man's daughter. I passed the baton back to him and forwarded his concerns through the appropriate channels. I never did find out if the films surfaced.

At best, his daughter's care was delayed only briefly. Or perhaps they had to spend the extra money and time to have the films repeated and shipped again. I hope the costs of that delay were nothing more than dollars and inconvenience.

It's an anecdote, yes. And not all cases of misplaced records have such dire consequences. But it's a scenario that repeats itself often enough to make us all cognizant of the need for better methods.

Information technology is part of the solution. I recently attended a meeting of the Radiological Society of North America where vendors from around the world displayed their ability to record, transmit and store digital images using everything from wires to satellites. Such technologies are revolutionizing the delivery of health care.

Satellites can fall from the sky and computers can crash, of course. We've all experienced the five stages of grief after accidentally destroying that irreplaceable word processing file. But we've also learned that strategies for data backup can all but eliminate the fear of an unrecoverable loss.

Sometimes I feel the pangs of regret when I think about my decision to trade in my stethoscope and scalpel for a mouse and keyboard. I doubt you'll ever see the successful transmission of an electronic medical record as the heart-pounding climax on the next ER. And though it lacks the adrenaline rush of grabbing the paddles and yelling, "Clear!" I still find a quieter satisfaction in knowing that the work I and many of my colleagues are doing in this field will save money, time – and yes, even lives.

© 1999 Ross D. Martin, MD, MHA

Adapted from the my editorial for the May 1999 issue of Essential Informatics for Medical Groups, co-published by Aspen Publishers, Inc. and the Medical Group Management Association.

Ross D. Martin, MD, MHA
Copyright © 1999 Rockin' Doc Media. All rights reserved.
Revised: January 03, 2006.