First the Links

  • Apple iPhone and Unbound Medicine hook-up
  • This is interesting because it lead to the health webification of consumer gadgets
  • Business Opportunities for the cut-price Provider
  • Uninsured numbers could be an indication that pricing of insurance premiums are out of whack with a large portion of regular Americans. It could be viewed that the pricing model is worng and an enterprising person my be able to take advantage to deliver cut-price services to this increasingly “untouchable” population
  • NY Times Tele-Doctor initiative in Hawaii, also here, here
  • To what extent can services be delivered across the web. Some players are going to try and they should be applauded for their initiative and innovation. Should this prove successful, they should also be applauded for their graft and dedication to their ideas.

And now for the Kitchen Sink

  • The Cultural Movement – Think Coronation Street
  • The wart-and-all approach. I wanted to view the modern day situation through
  • The Art – here, here
  • The Movie won awardsNot this one though
  • I really wanted to promote the New Zealand Film Commision. Some amazing film is produced under the auspicies and with the assistance of the NZFC. Big-ups.

The Kitchen Sink mentality may be a good topic to explore in relation to the financial meltdown and current economic perils.

In fact, I’ll do just that.

Have you ever wondered…

…after retracting abdomens and clamping vessels, where oh where do all the old surgical instruments end up. My first thoughts:

  1. Hospital Instrument Museums – finite capacity here
  2. Landfill (in a sharps container of course)
  3. Melted down to produce LOTR rings

Not so, as a creative colleague has shown with these images.

Codman Instuments a piece of Kauri

Codman Instuments a piece of Kauri

Codman Instruments and a nice badge in Kauri

Codman Instruments and a nice badge in Kauri

Abdo Retractor coat rack

Abdo Retractor coat rack

Apparently his wife banned him from whipping up a speculum hat stand.

I can imagine old MRI’s stacked into a fun slide for the little ones.

Following Mashall Kirkpatricks lead

My dog Lily got a good walk today. My podcast selection consisted of:

  • Adaptive Path – Semantic Technologies (44:08)
  • eHealth Trends, Manhattan Research – Twitter for Health (5:46)
  • eHealth Trends, Manhattan Research – Future of PHR (6:30)
  • The Web2.0 Show – Jeff Barr, Amazon Web Service (27:35)
  • NPR Live Concerts – Wilco Sampler (17:30)

That’s pretty far alright – Right round the park, up past the creek, through the school rugby field (twice). In fact it’s farther than her usual route which is approximately:

  • Entrepreneurial Though Leaders – Choosing The Entrepreneurial Path, Reid Hoffman (1:03:19)
  • iinovate – Chip Heath, Author of Made To Stick (14:38)

You can’t really imagine what goes on in the old grey matter when you blend all that together with walking/jogging. Its a great way to squash a whole bunch of ideas into each other. There is so much going on in the health2.0 scene at the mo… and simultaneously trying to keep up with TechCrunch + Gizmodo + ReadWrite + Church of the Customer + O’Reilly Radar + Feld Thoughts.

My solution: Walking the dog and Driving the car… this really helps suck in the necessary info and ignite the bloody great blast furnace.

Oh, and I prefer the Aerosmith version…

The New Yorker ran a great article in December last year on complexity and simplicity in the medical setting – specifically around the Critical Care environment (subsequently, the NYTimes has also followed suite with a version citing surgical checklists and safety). Both refer to the NEJM study by Dr. Atul A. Gawande.

As I sat reading this after a hard day grinding the gears, I realized my life really wasn’t all that hard if the truth be told.

Peter Pronovost is an inspiring legend. Seemingly indefatigable as a fellow earth-dweller, he is all at once an ebullient, enthusiastic personality with a realistic enough cast to understand that even the most expert of human performance is still just that… well err… human!

As some have poetically said  – “To Err is Human” and we humans, set in such overwhelmingly complexity can commit many (and grave) errors with serious outcomes for our ecosystem.  But to forgive oneself for committing the errors is truly divine. I would have to consider if modern medicine is educating certain individuals with that predilection to truly believe they are incapable of such errors – the infallible right hand of God so to speak. Is it cognitive arrogance to believe that we can remember every crucial detail in such environments as the ICU, OR or even the cockpit of a commercial airline? Failure is not an option.

The intense focus exhibited by people like Peter Pronovost, who become a super-specialist – further than a specialists –  is amazing. Its also life altering and personality changing work. When people put such intense effort into an endeavor, a lot of their personal image becomes rightly invested in that character. Following a list seems like a smack in the face of that persons intelligence and abilities.

Also,when someone has a great idea that is validated and lauded by their peers and society, it becomes hard for them to escape that idea in future. They are forever perceived as the “Wikipedia Man” or “Mr Facebook”. Does that cloud their thought processes about other, perhaps non-related, environments or actions? I would say yes it may well do.

To exhibit that form of self-reflexivity when approaching a new idea is really an awesome feat. The tendency would be to rely on the point of view that garnered such attention and accolade. It’s sure is hard to think about me thinking about thoughts. But Peter Pronovost did just that by shedding his education and super-specialist approach to see the lifesaving beauty and utility value in constructing simple lists. That’s “simple elegance”.

Just as some of our (grand)parents carry the Deppression Era mindset with them – frugality above all else –  So to does our recent successful idea/action stay with us and affect our future actions.

Where am I going with this….

I think the combination of a disciplined regiment coupled with an attitude and some aptitude will lead to great ability and this may just be the path to excellence.

Oh, and also “Write a List” man…

Seems ReadWrite’s Richard MacManus has a take on web apps and health systems. It’s a positive/negative statement that those who brush up with health systems can relate only to well.

Yes, yes, yes (enthusiasm building), yes, ohh (seeds of doubt creeping in, distrust blooming)….. OK (we need to gather evidence around this area), hmmmmm!

The evidence-based approach to medicine is great and absolutely necessary to honor the “first do no harm” doctrine. But other administration areas that are required to maintain medicine and healthcare are as resistant to any efficiency changes as anything I have seen. An example – The act of networking and centralizing surgical video is a vast and convoluted undertaking with all stakeholders undermining one another to protect their areas.

Clay Shirky’s book – Here Comes Everybody – has been a great read so far around groups and organization. It clearly illustrates costs to organizing groups and the reduction associated with new web technologies. Are there any more bureaucratic, slow to change, jargonistic fields than healthcare (law, religion) ripe for these web technologies, first on the fringe, then right to the core of health and medicine services?

Sadly Richard, perhaps one year of red tape is optimistic! Where are the Influentials to charismatically push health into the 2.0 era?

I’ve just digested the Wendell Berry essay In Distrust of Movements
A great little thought-provoker that can really open up a can of whoop ass for many, many different areas of protest and change.

It seems the original ethos and even specific logos around the birth of a movement often gets subverted the more (uncritical) participants that become involved. Each member brings their own unique frame of reference and perceptive filter to the proceedings. The incremental shift (sometimes tumultuous, power-wresting, blood-spilling divergence…) gradually alters the landscape until well-meaning pioneers and originators look around them and exclaim in dismay – I’ve Created A Monster!!!

…Perhaps not that severe an example, but still…
The incredibly passionate people who drove the movement from it’s foundations look back in bitterness and some small portion of self-loathing to a creation that is different from anything they had envisaged.

In light of global economic collapse – Movements for This, Movements for That – should be seen for what some of them are: A knee-jerk reaction to a terrifying set of circumstances and individual occurrences (in terms of financial hardship) that cannot simply be viewed individually, but will definitely be seen collectively. Is the next guy “righter” just because he had another opinion?

Additionally, I’d really like to see an ANT (Actor Network Theory) take on the current economic situation. Trying to pair off the inputs of technology, society, individuals and their actions in a network will take some heady scholarship to accomplish – good luck you young, enthusiastic business school PhD student (with sociological leanings)!!!
When you sift through the screeds of data – economic, social, crazy crap – I’ll read your dissertation Matey Potatee.