2012 in Review

2012 in Review

2012 was a very special year for me, perhaps even the best year of my life. Here are some of the biggest lessons I learned in 2012.

Gedankenexperiment makes me a great Architect

“his great breakthroughs came from visual experiments performed in his head rather than the lab. They were called Gedankenexperiment — thought experiments” ~Time Magazine Writes about Einstein, 4/20 of 20 Things you need to know about Einstein

The prevalent theory of lateralized cognition in a nutshell is that one hemisphere manages abstraction of math and words while the other focuses of pattern recognition. Most people show dominance in one or the other, either being very philosophical, linguistic or mathematically inclined or being very artistic and creative.

Typically engineering and architecture is done by the former, and hardly ever by the later. What has been my advantage as an Architect in this field is my inclination to both. I often have very visual ways of explaining complex abstraction – which make it easier to get everyone on the same page and thinking more creatively about how to solve problems.

I have been an Architect, putting together plans that map requirements to technology, to measures of expectation and success, to methods of execution, buy-in, financing and change management to models for use, profit and opportunities afforded by such technology for 13 years now – but I have never had a benchmark to measure myself against.

In 2012 I have had the privilege of meeting and interacting with people far more experienced and brilliant than myself, many of whom I admire and their validation of my work, plans and methods have really given me confidence that I am really good at this.

Healthcare needs transformation now

“When a great need converges with new capability afforded by technology, you have the beginnings of a revolution.” ~Loosely adapted from Thomas Friedman

When I first took this portfolio as a Hospital CIO 3 years & 10 months ago, I was aghast at how primitive and anorexic IT was in the trenches of the delivery of healthcare. The industry was struggling with issues I considered basic, such as streamlined workflows, Data Management, Analytics of Information from various silos and the need for Platforms for Collaboration – Issues solved by IT in other Industries. Your banking information today can follow you today across multiple banks and points of services, can be accessed and managed online and has a 360 degree view of you to service providers to understand you as a customer, credit risk and opportunity. This is made possible by various connected enterprise data management layers that connect banks and other service providers.

Now imagine if you applied such technology to healthcare, which is already rich with data being acquired by specialized life science systems and information from mature medical knowledge bases – and gave Clinicians and everyone involved in the delivery, planning or financing of care a 360 degree view of the patient, a cohort of patients or an emerging trend over a measured demographic. What a transformation this would bring to healthcare!

Another exciting breakthrough in technology in the last 5 years is the ability of computers to understand human speech and text in Natural Language – applied to the delivery of care this will enable analytics on the 80% of legacy healthcare information that is unstructured. This technology will also enable automation of medical records, with computers being able to listen in to interviews between the Clinician and Patients and other Clinicians and significantly reduce the work and errors that come from Clinicians documenting manually.

Such technological enablers are the obvious answer to some of the needs we see in the local healthcare market – such as the need for efficiency to maximize the outcome per dollar spent, to derive better margins by driving down cost rather than raising prices, the shift towards Primary Care as gatekeepers to reduce cost of Government provisioned healthcare, an aging population and shifting disease burden to chronic care & the new emerging informed patient looking to participate in the management of their care.

Strong information management will enable better evidence based strategies and care management which is fundamental to addressing the challenges I mentioned above. So we are now in this point of convergence where great needs can be addressed by technological capability – so the time for a revolution is now.

People make a difference in implementing Technology

“A power drill is useless in the hands of a monkey” ~Dr HM Goh, Medical Director, UMSC

One of the biggest and hardest lessons I have learned in 2012 is that the partners and implementors you choose for a complicated technology project matter more than the actual technology you choose. I have seen great technology nullified by a bad implementation. It was a real wake up call for me to begin to understand that the more sophisticated your users are, the less sophistication they need from their tools. One button fix all apps are usually needed by the less sophisticated users – which is ironic because these tools cost more as they require a lot of sophistication during the implementation. So your left as a CIO to make a judgement call, if your users are simple you need sophisticated vendors, if your vendors are simple, you need sophisticated users. You will end up spending the money anyway – its either going to your payroll or to the contract with the vendors.

The worst case scenario is when you have simple users, simple vendors trying to choose and implement a system for a very complex environment. The end result will be failed projects, sunk cost and ugly legal battles.

Healthcare needs Coopetition, not competition

“Trying to be number one and trying to do a task well are two different things” ~Alfie Kohn

Healthcare is a very complex industry, it needs to be funded, often by rightly dividing between what should be a fundamental right and what is a privilege. It has to be continuously optimized by expensive Science and Innovation – and all our lives depend on getting these factors right. It is therefore not conducive to have scenarios of zero-sum-games in this industry, as there is always a trade of to overall cost or efficiency.

Therefore business people who invest in healthcare, technology players who focus on this market, often have to learn to move from models of traditional competition to coopetition for best outcomes. In 2012 I managed to get the fiercest of competitors to work together to pull of projects with extreme constraints of time, resources, people or technical challenges. Coopetition even works well for Care Delivery, with a shared Medical Record over an EHR, competitors can deliver better care while trying to compete for that patient’s loyalty.

In a nutshell, the biggest lesson of 2012 is to keep our eye on the prize – Decision support for Clinicians and a Healthcare record that follows patients through their lifetime providing continuity of care, collaboration between all the care givers they will need and the ability for them to participate and understand their health, risk and needs. This goal can be done now, with the right leadership, strategies, partners and technologies. In fact there has never been a better time for it.

Categories: HIT

One thought on “2012 in Review

  1. Hi Leon, These are sound and healthy learnings, and when focused on the end game (Decision support for Clinicians, Healthcare record that follows patients through their lifetime providing continuity of care, collaboration between all the care givers they will need and the ability for them to participate and understand their health, risk and needs) will pay significant dividends.

    cheers Pankaj Fichadia

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