This post from November 26th, 1999 – was the first on this blog. There were a few months of previous posts, but due to several platform changes back then – these seem to be lost.
No matter. 12 years is a long time. My blog is now officially an adolescent. I wonder what it will be when it grows up! Long-time readers are of course observant that I've been remarkably quiet for the past few years. This is due to my evolving work for an HIT vendor and now the Federal Government.
So I've been operating with this in the background for the past six years:
The opinions expressed on this blog are my own and do not represent the veiws of my employer.
And there is a rough "social media policy" (google docs – you have edit rights .. feel free to steal or enhance … ) that I have in my head as well .. so in general I have done my best to observe and occasionally point to important publicly available information, but take care not to comment too deeply – for fear that others would interpret my commentary as a telegraph of my employer's next steps. This wouldn't be appropriate for me to share – and increasingly – I am concerned that most of my public thoughts could be interpreted in this way – so I've been holding back from any public commentary.
So for now – here we are.
I'll push the envelope a teensy bit and comment on some events of the past few months:
Tim HISTalk covered my arrival at ONC in a post about a month ago. He asked the right questions about the topic at hand – but he didn't get to the one that I am hearing often these days – which is .. "Why did you leave your leadership role at one of the top health IT companies, choose to spend weekdays away from your family, AND (with two kids in college) take a giant pay cut?"
The answer is easy: It's the right thing to do.
Health Care in the United States is at a turning point. It is well known that despite great advances – we don't provide the quality of care that we would. It is also self-evident (to me) that technology – carefully applied – will improve both the quality of care – and the efficiency, sensitivity, and ease with which it is delivered. Yes – some of those words may not be familiar to you – but why WOULDN'T we want it to be EASY to deliver great care? Why shouldn't we deliver SENSITIVE care (sensitive to your hopes, religion, fears, preferences) – in addition to efficient, evidence-based and (of course) cost effective) care?
So I have always tried to focus my work on helping others meet their true potential. In my first career – as a 16 year old sailing teacher, I helped kids find the freedom and autonomy that a good breeze and a sunfish will provide. As a teacher of junior high school kids – I witnessed breathtaking intellectual growth in a herd of 12 year olds who were otherwise distracted by adolescence and its daily challenges. Working with (some say "caring for") patients as a family physician - I found that my most important work was not to take control and "fix" my patients (as some of my mentors had advised in medical school) but to partner with my patients – serving as a resource – without any judgment or critique. As Bill Miller and James Prochaska have demonstrated (motivational interviewing, transtheoretical model) – people change when they choose to – and no sooner. Can we facilitate growth in others? Of course we can. But "facilitate" and "cause" are inherently different.
As a leader in a large health IT software company – my role was often to help our teams align the software products we were producing with the needs of our customers. This is not unlike the role of a good physician: we need to listen carefully and critically so that we understand the needs (which will sometimes differ from the "wants") so that we can facilitate success.
And isn't that the role of government too? Perhaps that's a political question. Some would argue that government should get out of the way, while others would argue that there is an important role for government to provide an infrastructure with which success can be facilitated. Is a healthy happy nation something that is important? Are there ways that government can facilitate a migration toward these goals?