Gregory Schmidt, MD: Recent Episodes
Gregory Schmidt MD
Healthcare remains one of the least digitized sectors of the economy. Article: https://www.gregoryschmidt.com/articles/healthcare-digitization-index
Between 1990 and 2007 healthcare was the second worst sector of the USA economy in productivity improvement. In fact it had become less productive with time.
Article: https:/www.gregoryschmidt.com/articles/healthcare-productivity-2014
Countries spend more on healthcare each year than their economy grows. Can this continue forever? Article: www.gregoryschmidt.com/articles/growth-healthcare-vs-gdp #HealthEcon
CBC News published an article on Nursing Day that provoked public outcry. It turns out that the details of the original article were incorrect. CBC proceeded to rewrite the article (a new headline, byline, and content) but the new article was published overtop of their existing article.
The addition of single-sentence summaries can dramatically improve the information communicated when generating summaries of patient data. This example focuses on trying to display that two consultations occurred in the same day.
Article: https://www.gregoryschmidt.com/articles/single-sentence-summaries
When we fit the patient's narrative into a typical medical story arc, we risk making diagnostic errors.
Article: https://www.gregoryschmidt.com/articles/risks-of-using-medical-story-arcs
Sometimes it is not clear which side of the box should be opened.
Article: https://www.gregoryschmidt.com/articles/le-creusets-box
Do we even need letters in the code? Are number only codes preferred? Article: https://www.gregoryschmidt.com/articles/two-factor-design
Summarizing the patient's narrative into a medical note introduces error into the earliest steps of the diagnostic and record-keeping process. Article: https://www.gregoryschmidt.com/articles/the-patients-narrative-is-never-written-down
The original first-person patient narrative forms the foundation of clinical medicine, yet its original form rapidly becomes contaminated and evolve once the patient enters the medical system.
Article: https://www.gregoryschmidt.com/articles/patient-first-person-narrative
Narrative language is everywhere in medicine. How does this influence how we think & document patient information?
Article: https://www.gregoryschmidt.com/articles/narrative-language-in-medicine-intro Custom fields
Back-in angle parking combines the benefits of angle parking with those of bcak-in parking.
Article: https://www.gregoryschmidt.com/articles/reverse-angle-parking
In some countries most cars back-into parking spaces. In other countries, almost nobody does. Why is this? Article: https://www.gregoryschmidt.com/articles/why-do-americans-not-back-into-parking-spaces
Help reduce backover injuries and fatalities with these ideas.
Full article: https://www.gregoryschmidt.com/articles/ways-to-avoid-fatalities-from-car-backovers
Each week in the USA, an estimated 280 people are injured and 4-5 people die as a result of backover injuries. Most of them children.
Article: https://www.gregoryschmidt.com/articles/backover-deaths
Costco puts extra space between their parking stalls which ensures cars are always centered in the extra-wide parking stall.
Full article: https://www.gregoryschmidt.com/articles/extra-wide-parking-stalls
2020 was quiet year for new posts on this website, but busy year for Gregory.
Read at: www.gregoryschmidt.com/article/life-update-2020
It may make the most sense to encourage clinicians above a certain age, and those with comorbidities to focus as much as possible on telemedicine care to reduce their risk of mortality from coronavirus.
Summary of the step-by-step process taught by Kevin Starr to design for building lasting impact at scale. Original article: http://www.gregoryschmidt.ca/writing/lasting-impact-at-scale-kevin-starr
Do not teleport your users to different parts of the application. They must take a road to get there, and know which part of the app's 3D space they are in. Original article: http://www.gregoryschmidt.ca/writing/app-design-positional-space
Navigation options starting with mobile: On-page / Bottom tab / Top tab / Side navigation drawer Combining navigation patterns: acceptable & not Original article: http://www.gregoryschmidt.ca/writing/navigation-options-starting-with-mobile
The major user interface regions of the PATIENT FILE Original article: http://www.gregoryschmidt.ca/writing/patient-file-ux-regions
If you are designing on the web, Android, or iOS, a pixel is probably not what you think it means. Pixels, Points, and Display-indepdnent pixels Original Article: http://www.gregoryschmidt.ca/writing/when-is-a-pixel-not-a-pixel-pixels-points-dps
If 1080p is 2x as vertically dense as 720p, Why is 4K not 4x as vertically dense as 1080P? Original Article: http://www.gregoryschmidt.ca/writing/why-4k-is-misleading
Mobile phones and tablets advertise Height x Width x Depth ? This seems backwards. Original article: http://www.gregoryschmidt.ca/writing/why-are-phone-dimensions-backwards
Almost always write the HORIZONTAL dimension first, the VERTICAL second. Unless, you are a fine art dealer or mobile phone manufacturer. Original article: http://www.gregoryschmidt.ca/writing/writing-dimensions
The book for organizations and individual who measure their success not in terms of dollars and cents, but by their social impact. It challenges us to think big, start small, and relentlessly seek impact. http://www.gregoryschmidt.ca/writing/lean-impact-detailed-summary
Who are the doers at scale? Who is the payer at scale? Lessons from the book Lean Impact by Ann Mei Chang and work of Kevin Starr. Original article: http://www.gregoryschmidt.ca/writing/engines-of-growth-in-social-impact
How philanthropic & grant based funding differs from traditional startup venture capital. Rigid waterfall grants. Small linear steps. Unscalable solutions. Original article: http://www.gregoryschmidt.ca/writing/why-philanthropy-hampers-innovation
The entrepreneurship startup principles of Lean Startup, applied to social ventures as described in Lean Impact. How to build a social impact project that scales. Original Article: http://www.gregoryschmidt.ca/writing/lean-impact-lean-startup-brief-summary
The WORKFLOW section of the medical record completely transforms the EHR experience and clinical care. It is much more than just a form. Original Article: http://www.gregoryschmidt.ca/writing/the-patient-workflow-is-not-a-form #EHR #EMR
The Patient File contains the Patient Chart & Patient Workflows. The design of the Patient Chart is generalizable, the Patient Workflows highly use case specific. Original Article: http://www.gregoryschmidt.ca/writing/what-is-the-patient-file #EHR #EMR
Ranking of 6 different strategies to search for patients Original Article: http://www.gregoryschmidt.ca/writing/search-for-a-patient-in-the-ehr
In a clinical EHR, the first job of the HOME screen is to be bypassed quickly to get the PATIENT FILE open Original Article: http://www.gregoryschmidt.ca/writing/purpose-of-the-ehr-home-screen
The entire EHR can be reduced down to (1) HOME: patient identification & (2) PATIENT FILE: see info, enter info Original Article: http://www.gregoryschmidt.ca/writing/simple-ehr-workflow
The many tasks of an EHR can be simplified into three major tasks. A simple EHR can be built with only 2/3 of these tasks. Original Article: http://www.gregoryschmidt.ca/writing/3-essential-ehr-tasks
EHR performance speed is very important to the user experience; but their are two very different sources for the cause of slowdowns. Original Article: http://www.gregoryschmidt.ca/writing/ehr-speed-root-cause
Start with features that are immediately useful to the clinician logged into the EHR. Do not start by promoting delayed benefits for others. Original Article: http://www.gregoryschmidt.ca/writing/ehr-immediately-useful #EHR #EMR
What are the attributes clinicians look for in an electronic health record? Original Article: http://www.gregoryschmidt.ca/writing/ehr-atributes-for-clinicians #EHR #EMR
Can we build an electronic health record tool that clinicians eagerly want to use over their paper-based workflows? Original Article: http://www.gregoryschmidt.ca/writing/build-an-ehr-clinicians-want-to-use #EHR #EMR
Who is the true customer in enterprise medical record software? Who do we build EHRs for? Let’s move more influence downstream to the patient, and those that care for them. Original Article: http://www.gregoryschmidt.ca/writing/ehrs-who-do-we-build-this-for #EHR #EMR
Three methods that work well together within the same cross-functional team.
Original Article: http://www.gregoryschmidt.ca/writing/design-thinking-lean-startup-agile
How does one bring the buzzword of innovation, and principles from The Lean Startup into a large open-source community? Original Article: http://www.gregoryschmidt.ca/writing/org-model-for-innovation-within-open-source-community
A must read for anyone trying to do something new (within an existing organization, or a new venture).
Original Article: http://www.gregoryschmidt.ca/writing/lean-startup-book-summary
Are you slow and non-reusable? There are at least two routes to operating fast and very reusable. Original Article: http://www.gregoryschmidt.ca/writing/speed-vs-reusability #Startup
Healthcare in America is fragmented for patients, caregivers, providers, payers, and the public. Herein lies the opportunity. http://www.gregoryschmidt.ca/writing/healthcare-fragmentation
Level 1 to Level 2 is a shift to systems where a significant amount of care is provided by healthcare workers, using digital health tools, in integrated systems. http://www.gregoryschmidt.ca/writing/three-levels-of-health-system-technology
April 2, 2019 Design Call Discussion of proposed starting point for collaboration on new frontend application. "OpenMRS Flow - Concept Paper" Read Original Document: https://docs.google.com/document/d/11Z7ploIaZsMxGwlhqYavMH3WjlwwwoKD_nKvPnvH0lw/edit?usp=sharing Comment on Talk Thread: An amazing future for OpenMRS https://talk.openmrs.org/t/an-amazing-future-for-openmrs/22328 #OpenMRS #EHR #Design
Why design may improve or ruin your life 1. What is design? - Design is how it works - Is design good or bad: what is its purpose? 2. Design Evolves - Design follows technology - Design follows product turnover 3. Design skills for engineers - Importance of demos - Trained gut response Recorded: Facebook Developer Circles: Eldoret, Kenya March 30, 2019 #Design
How bad really is the state of many EHRs today?
What design problems will EHRs face in the future?
Design must achieve a purpose What is the purpose of an Electronic Health Record?
http://gregoryschmidt.ca/writing/the-role-of-design-in-ehr
#EHR #Design
How do we design an EHR platform that makes collaboration easy? Horizontal and vertical modularity is key. Images & text http://www.gregoryschmidt.ca/writing/openmrs-3-modularity-principles #EHR #Design #Modularity
Pretty much everything is highly modular. The world wouldn’t function without it. Modularity makes it possible to build quickly and cost effectively. http://www.gregoryschmidt.ca/writing/modular-design-first-principles-from-the-physical-world #Design #Modular #Modularity
It is embarrassing that healthcare does not assess its quality with the same rigour of other industries. Measure medical quality in real-time, in the real-world. http://www.gregoryschmidt.ca/writing/quality-in-medicine-upper-vs-lower-limits #EHR #Quality #Patientsafety
At the airport I saw a gun appear on the x-ray scanner. Van Halen refused to allow Brown M&Ms on stage. Real-time quality checks are a critical part of any industry. http://www.gregoryschmidt.ca/writing/guns-van-halen-mms-real-time-quality-checks #Lean #Quality #Patientsafety
Interoperability between clinical systems is long overdue, but it is not enough to drive the innovation we required in electronic health records. Ultimately, we require interoperability between the functional components within a clinical system. http://www.gregoryschmidt.ca/writing/interoperability-is-not-enough #EHR #Interoperability
EHR Order Entry, Part 5 - EHR Design from first principles: the connect between orders and action. Why connection of order and action help create systems, and avoids fragmentation. http://www.gregoryschmidt.ca/writing/order-entry-ux-first-principles-order-action #EHR #Design #Systems
EHR Order Entry, Part 4 - How does Knowledge & Orders connect? 1. Why orders exist - to turn knowledge into action 2. The different types of order tools to do this 3. The huge gap between order entry based on these first principles, and how it actually is done today http://www.gregoryschmidt.ca/writing/order-entry-ux-first-principles-knowledge-orders #EHR #Design #CPOE
EHR Order Entry, Part 3 - Order entry can be divided into two categories of tools. 1) Order Selection (Drug Selection) - many UX tools 2) Order Customization (Drug Customization) - a single UX tool Let’s look at this division in more details http://www.gregoryschmidt.ca/writing/order-entry-ux-order-selection-vs-customization #EHR #Design #CPOE
EHR Order Entry, Part 2 - Examples of order entry UX in medical records. Detailed order entry and order sentences Original Article http://www.gregoryschmidt.ca/writing/order-entry-ux-eg-order-entry-and-order-sentences #EHR #Design #CPOE
EHR Order Entry Part 1 - General requirements for a medication order entry system http://www.gregoryschmidt.ca/writing/order-entry-ux-general-requirements-meds #EHR #UX #CPOE
Looking for a list of all healthcare worker occupations divided into official categories? There are at least 50+ large groupings of healthcare workers, and an additional 300+ occupational examples based on these International Classification Standards. Download the spreadsheet list at http://www.gregoryschmidt.ca/writing/international-classification-of-health-workers #WHO #Healthcare #ISCO
Ken Kocienda gives an inside look into Apple’s software development process during his 15 years at Apple. He was there during the release of Safari, iPhone, and iPad. The book is a must read for anyone who develops products or is interested in Apple. This post highlights some of my favourite themes from the book. http://www.gregoryschmidt.ca/writing/book-highlights-creative-selection #Apple #Design
5 minute lightning course on EHR User Interface Design. Covers first principles, foundational components, and the future of electronic health records. This was presented as part of the Lightning Talks session at the OpenMRS Conference in Nairobi, December 2018. http://www.gregoryschmidt.ca/writing/ehr-design-omrs18-lightning-talk #EHR #UX #OpenMRS
A way to brainstorm, team build, and strategic plan in a very large group
Original Article: http://www.gregoryschmidt.ca/writing/brainstorm-how-might-we
Summary of 1551 ideas generated in one hour at the OpenMRS 2018 Conference. Original post with full details at - http://www.gregoryschmidt.ca/writing/openmrs-2018-conference-brainstorm-session #OpenMRS #OMRS18
Slides/text at http://www.gregoryschmidt.ca/writing/concept-electronic-health-record-april-2016
Cool EHR user interface mockups - The Concept Electronic Health Record - April
2016 ----- The Concept Electronic Health Record (C.E.H.R.), was a project from a research block in second year General Internal Medicine residency. The project was presented April 2016 at the University of Manitoba Resident Research Day. It won the Residents' Choice Award for Best Podium Presentation. At that time, the presentation was a slick 10 minute pitch. I have entirely forgotten the script from that presentation. Therefore, a new commentary was written for this post. It also goes into far more detail than originally presented.
#EHR #EMR #UX #UI
EHR workflows should be assigned in real-time, based on the patient’s issues and resources available. Article: http://www.gregoryschmidt.ca/writing/workflows-3-levels #EHR #EMR #UX
Is this true? Confirming validity of Past Medical History data The truth of medical data rests on the ability to validate it against primary source material http://www.gregoryschmidt.ca/writing/confirming-validity-of-past-medical-history #EHR #EMR #UX #UI
Article: http://www.gregoryschmidt.ca/writing/problems-with-past-medical-history-data
---- Summary: “Do not believe anything you read in the patient’s chart - it is full of lies”.
This was the first lesson taught to new medical students by our hospital’s most esteemed diagnostician. I have found this assessment generally to be true - both for paper and electronic medical records. However, in theory, we should be able to remedy this problem with electronic medical records.
This post is written across two parts, Part 1: (i) how do we determine if data in the past medical history is true, (ii) how fake data enters the medical chart, and (iii) in practice, how do clinicians verify the truth of medical data?
Part 2 proposes ways to help verify medical diagnosis.
e-mail gschmidt@medmb.ca
Twitter @_GregSchmidt
‘Auto-populated data’ should be stored different from ‘Original data’ in electronic health records http://www.gregoryschmidt.ca/writing/auto-populate-ehr-data-vs1 ----- Summary The auto-population of data fields is a key benefit of electronic medical records over paper. However, there are two issues that need to be addressed in order to minimize error and reduce the chance that garbage data is created. First, a system is needed where users have an opportunity to confirm if the auto-populated data remains ‘true’ or has changed. Second, the auto-populated data must be stored in a way where it is tagged different from original data. But first, a comment on the benefit of auto-populated data fields.
Required fields can be the portal for garbage data to enter electronic medical records. Here are some ways to prevent that. http://www.gregoryschmidt.ca/writing/required-data-fields SUMMARY 1. Why is this field required? 2. Workarounds on paper required fields 3. A rational approach to: required fields 3.1 Establish a high criteria to make a field required 3.2 Anticipated Expiration Date 3.3a Allows users to skip completing a required field 3.3b Create an internal audit system to track usage of the opt-out feature 3.4 Show the ‘justification’ for the required field 3.5 Be open to feedback 4. Next steps
No desk space? Stack them vertically http://www.gregoryschmidt.ca/writing/vertically-stack-monitors
Entrance complaint: "patient says his sports heart rate monitor is acting up” Article: http://www.gregoryschmidt.ca/writing/sports-heart-rate-monitor
Is our peacetime today attributable in part to the collective memory of the horror of the past? Original Article: http://www.gregoryschmidt.ca/writing/remembrance-day-the-forgetful-generation
Navjunk = is excessive ornamentation of navigation systems that distracts from actually helping people find directions
#navjunk is Edward Tufte's #chartjunk, applied to direction systems. #UX
Post ends with example of an excellent hospital patient navigation system "The Route Navigation" at Radbound UMC
Article: http://www.gregoryschmidt.ca/writing/navjunk-vs1
These floor arrows help patient’s escape from the medical clinic. Original Article: http://www.gregoryschmidt.ca/writing/medical-clinic-floor-exit-arrows
An offline medical record is a lot more complicated than it first appears. Original Article: http://www.gregoryschmidt.ca/writing/the-offline-medical-record-problem gschmidt@medmb.ca
“And now when the computer people move in… and the non-medical people move in, they can hardly believe what they see. And there is a crisis of major proportions.” Original Article: http://www.gregoryschmidt.ca/writing/dr-larry-weeds-1971-lecture
The Top 50 Most Interesting Ideas of Exponential Medicine 2018. Original Article: http://www.gregoryschmidt.ca/writing/exponential-medicine-2018-top-50-ideas
Summary slide / text available at: http://www.gregoryschmidt.ca/writing/exponential-medicine-day-4-2018 Exponential Medicine, Day 4 - Cool Stuff Summary (Nov 7 2018) A collection of the most interesting ideas and slides of the day. ----- Sessions / Speakers Exponential Medicine, Day 4 - Cool Stuff Summary (Nov 7 2018) NOV 7 Exponential Medicine, Day 4 - Cool Stuff Summary (Nov 7 2018) FUTURE TECHNOLOGY A few notes from the last day of Exponential Medicine 2018 - Day 4. I was able to watch via live-stream on YouTube. You may be interested in the Notes from Day 1, or Notes from Day 2, or Notes from Day 3. Day Four Wednesday, November 7, 2018 Session 23: The Morning After? Politics, Policy & What Just Happened Session 24: Augmenting Biology and Reversing Aging 24.1 Andrew Pelling Scientist & Founder, Pelling Lab 24.2 Amy Wagers PhD Professor of Stem Cell and Regenerative Biology, Harvard University Pioneering Longevity with Peter H. Diamandis & Bob Hariri Peter Diamandis MD Executive Founder and Director, Singularity University, Founder and Executive Chairman, XPRIZE Foundation Bob Hariri, MD, MPH Founder, Chairman & CEO, Celularity David Karow MD PhD CEO, Human Longevity Inc Osman Kibar PhD CEO, Samumed Art and Medicine with Andrew Paul Leonard Session 26: Crystal Ball: Creating the Future of Healthcare Janet Foutty Chair and CEO, Deloitte Consulting Doug Beaudoin Principal, Life Sciences & Healthcare, Deloitte Pat Combes Worldwide Technical Leader, Healthcare & Life Sciences, Amazon Web Services Diane Hammon Vice President and Chief Strategy Officer, Moffitt Cancer Center Session 27: Democratizing Technology for Global Health David Bray PhD Impact & Disruption Faculty, Singularity University, Executive Director, People-Centered Internet, President, Hu-manity.org Peter M. Small, MD Rockefeller Fellow Alex Kumar MBBS Global Health Physician, NHS National Institute for Health Research Ralph Simon FSRA Chief Executive, Mobilium Global Session 28: Converting Insights into Action: What Happened at xMed. What Does This Mean? What's Next? Tom Wujec Founder, The Wujec Group Will Weisman Executive Director, Summits, Singularity University Daniel Kraft MD Faculty Chair for Medicine, Singularity University and Founder & Chair, Exponential Medicine
Summary slide / text available at: http://www.gregoryschmidt.ca/writing/exponential-medicine-day-3-2018 Exponential Medicine, Day 3 - Cool Stuff Summary (Nov 6 2018) A collection of the most interesting ideas and slides of the day. ----- Sessions / Speakers Day Three Tuesday, November 6th Session 15: Exponential Organizations Salim Ismail Author, Exponential Organizations, Chairman, ExO Works, Board Member, XPRIZE, Global Ambassador, Singularity University Session 16: NeuroMedicine at the Frontier 16.1 Divya Chander MD PhD Neuroscience Chair, Singularity University 16.2 Matteo Lai CEO & Co-Founder, Empatica 16.3 Ariel Garten & Graeme Moffet Co-Founder, Muse 16.4 Mary Lou Jepsen PhD CEO & Founder, OpenWater 16.5 Eric C. Leuthardt MD Neurosurgeon, Director of the Center for Innovation in Neuroscience and Technology, Washington University in St. Louis Session 17: (im)Patient Innovators 17.1 Godfrey Nazareth President & CEO, X-Biomedical, Inc. 17.2 Mette Dyhrberg Founder & CEO, MyMee 17.3 Mariya Filipova Chief Innovation Officer, Anthem Session 18: Future of Work & Investing 18.1 Vinod Khosla Founder, Khosla Ventures 18.2 William Morris MD Associate Chief Information Officer, Cleveland Clinic Jennifer Radin, Deloitte Shawna Butler RN MBA Nurse Economist and EntrepreNURSE-in-Residence at Radboud University Medical Center Session 19: Care Reimagined; Connected, Digital and Virtualized 19.1 Jay Parkinson MD Founder & CEO, Sherpaa 19.2 Lara Jana MD Pediatrician, Associate Professor, Penn State 19.3 Walter Greenleaf AR & VR Thought Leader 19.4 Justin Barad MD Founder & CEO, OssoVR Session 20: Radical Interoperability John Mattison MD Chief Medical Information Officer, Kaiser Permanente John Nebeker MD MS Deputy CMIO, Veterans Health Administration Shannon Sartin Executive Director, Digital Services, U.S. Department of Health and Human Services Session 21: Lessons in Leadership Jason Tuschen & Jason Torey Former Navy SEALs, Randori Tech Session 22: Reshaping Pharma, Discovery & Trials 22.1 Noah Craft MD PhD CEO & Founder, Science 37 22.2 Mei Mei Hu CEO & Co-Founder, United Neuroscience 22.3 Onno Faber Founder, RDMD MEDy Awards
Summary slide / text available at: http://www.gregoryschmidt.ca/writing/exponential-medicine-day-2-2018 Exponential Medicine, Day 2 - Cool Stuff Summary (Nov 5 2018) ------------- Sessions / Speakers Session 6: On the Frontier of Biotech 6.1 Moira Gunn PhD Host, NPR's Biotech Nation and Technation Health 6.2 Andrew Hessel CEO, Humane Genomics and Nanotechnology/Biotechnology Faculty, Singularity University 6.3 Jamie Metzl JD PhD Author of Hacking Darwin: Genetic Engineering and the Future of Humanity and Senior Fellow, Atlantic Council Session 7: Digitizing Data, Health & Life 7.1 Ran Balicer MD MPH Director, Clalit Research Institute 7.2 Lonnie Rae Kurlander Founder & CEO, Medal 7.3 Poppy Crum PhD Chief Scientist, Dolby Laboratories. 7.4 David Karow MD PhD CEO, Human Longevity, Inc. Session 8: AI for Good: Clinical Acceleration 8.1 Rachel Thomas PhD Founder & Researcher, Fast.Ai 8.2 Alan Karthikesalingam MD PhD Google Deep Mind 8.3 Johann Fernando, PhD Chief Operating Officer, FujiFilm Healthcare 8.4 Rajeev Ronanki SVP & Chief Digital Officer, Anthem Session 9: Reimagining Regulation & Clinical Trials 9.1 Asif Dhar Principal, Deloitte Consulting LLP 9.2 Ashish Atreja MD MPH Chief Technology Innovation and Engagement Officer, Icahn School of Medicine at Mount Sinai 9.3 Hansa Bhargava MD Senior Medical Director, WebMD and Host of Medscape's Uncharted Medicine Session 10: Smart & Healthy Communities 10.1 Lucien Engelen Founding Director of REshape Center, Radboud University Medical Center / SUNL 10.2 Erik Gerritsen Secretary General, Ministry of Health, Welfare and Sport of Netherlands 10.3 Elizabeth Canis VP Strategic Initiatives, Anthem Session 11: Digital Surgery 11.1 Shafi Ahmed Professor of Surgery and Associate Dean, Barts Medical School 11.2 Carla Pugh MD PhD Professor of Surgery Stanford 11.3 Jean Nehme MD CEO and Co-Founder, Touch Surgery 11.4 Stefano Bini MD Professor of Orthopedics, UCSF Session 12: It's All About Timing: Health, Aging and Interfaces 12.1 Leerom Segal Co-Founder and CEO, Klick Health 12.2 John Brownstein PhD Chief Innovation Officer, Boston Children’s Hospital Professor, Harvard Medical School 12.3 Satchidananda Panda PhD Professor, Salk Institute for Biological Studies 12.4 Jeffery Bleich Founder and CEO Pulson 12.5 Julia Vishnepolsky MA LMHC R-DMT Expressive Arts and Dance Movement Therapist, Adult Day Health Care Session 13: Curing the Incurable Jack Kreindler MD Founder & Director, The Centre for Health and Human Performance Parker Moss Health Technology Entrepreneur in Residence, F-Prime and Eight Roads Session 14: Connecting the Dots: Solutions at Scale Rasu Shrestha MD MBA Chief Innovation Officer, UPMC Executive Vice President, UPMC Enterprises
Summary of the cool ideas and slides from Exponential Medicine Day 1 Presentations, November 4, 2018. Original Article: http://www.gregoryschmidt.ca/writing/exponential-medicine-day-1-2018
Good presentation, good upgrades to produce line. Original Article: http://www.gregoryschmidt.ca/writing/apple-event-october-30-2018-major-themes
You can tell how much money was removed from the ATM based on the length of the cash-spooling sound. Original Article: http://www.gregoryschmidt.ca/writing/atm-cash-spooling-sound
A quick chapter about hospital facility planning and design Original Article: http://www.gregoryschmidt.ca/writing/hhds21-facility-planning-and-design
A high level overview of some consideration in designing inventory systems. Original Article: http://www.gregoryschmidt.ca/writing/hhds20-the-shaping-of-inventory-systems-in-health-services
Selecting a time zone in Google and Apple calendar is terrible.
Original Article: http://www.gregoryschmidt.ca/writing/timezone-ux-problems
Summary: A helpful reminder the day before, to inform you that the first appointment is earlier than normal. Original Article: http://www.gregoryschmidt.ca/writing/calendar-reminder-for-early-appointments
Include a copy of the book’s skeleton outline with each Audible purchase Original Article: http://www.gregoryschmidt.ca/writing/audible-include-table-of-contents-headings-index
This chapter is too old. Don’t read it. Original Article: http://www.gregoryschmidt.ca/writing/hhds19-analyzing-decisions-using-datasets-with-multiple-attributes-a-machine-learning-approach
AMPATH Medical Record System (AMRS) Quick Overview How the AMPATH electronic health record helps patients, clinicians, clinics & counties, and researchers & industry. Prepared for Oncology/Hematology Conference 11 October 2018. Eldoret, Kenya Text / Slides: www.gregoryschmidt.ca/writing/amrs-at-oncology-conference-oct-2018
Another very brief chapter summary. Original Article: http://www.gregoryschmidt.ca/writing/hhds18-statistical-analysis-and-modeling
A Markov Devision Process may help a situation of uncertainty that involves sequential decision making. Original Article: http://www.gregoryschmidt.ca/writing/hhds17-markov-decision-processes-in-healthcare
Bed capacity cannot be assessed base on occupancy levels. As occupancy levels (utilization) increases, the queue grows exponentially. Original Article: http://www.gregoryschmidt.ca/writing/hhds16-queueing-theory-and-modeling
I left out the math, makes this chapter very short. Original Article: http://www.gregoryschmidt.ca/writing/hhsd15-an-introduction-to-optimization-models-and-applications-in-healthcare-delivery-systems
“I will not be part of this charade anymore” - Chamath Palihapitiya Original Article: http://www.gregoryschmidt.ca/writing/the-silicon-valley-ponzi-scheme
Computer simulation in healthcare needs to combine model developers with subject matter experts for best results. Original Article: http://www.gregoryschmidt.ca/writing/hhds14-computer-simulation-in-healthcare
This week I gave this presentation on deriving an EHR user interface design from first principles. It is based on my research so far, and leads to an EHR re-design mockup. The presentation is available at https://www.youtube.com/watch?v=gw0ClxQ-3Nk 70min. Looks best at 1080p :) The lecture has 4 parts - Introduction & EHR Requirements 0:00 - Part 1: Multi-Screen & Multi-Tasking EHR UI from first principles 7:36 - Part 2: A single user interface to group clinical data 6+ ways 23:37 - Part 3: Electronic medical record interface panel ideas 46:30 A copy of the text & slides are available at http://www.gregoryschmidt.ca/writing/ehr-design-mockup-oct-1-2018
Some high level ideas how to spread evidence-based practices. Original Article: http://www.gregoryschmidt.ca/writing/hhds13-toward-more-effective-implementation-of-evidence-based-practice
Failure Mode Effects Analysis helps proactively study possible sources of risk and ways to mitigate this. Original Chapter: http://www.gregoryschmidt.ca/writing/hhds12-patient-safety-and-proactive-risk-assessment
In the proliferation of personal health data, all roads lead to dystopia. John Hancock will no longer sell traditional life insurance policies - only ‘interactive’ ones that encourage sharing of activity data. Original Article: http://www.gregoryschmidt.ca/writing/john-hancock-to-stop-selling-traditional-life-insurance
Lean is a popular tool to improve productivity and organization in Healthcare. And it works. Original Article: http://www.gregoryschmidt.ca/writing/hhds11-lean-in-healthcare
The size of a physician practice can have dramatic effects on the length of the patient cue. Original Article: http://www.gregoryschmidt.ca/writing/hhds10-managing-physician-panels-in-primary-care
Tracking healthcare performance is difficult. Original Article: http://www.gregoryschmidt.ca/writing/hhds09-performance-assessment-for-healthcare-organizations
Healthcare engineering can propose some concepts to help integrate healthcare service delivery. Original Article: http://www.gregoryschmidt.ca/writing/hhds08-an-integrated-model-for-healthcare-delivery
Perhaps one of the worst Apple Keynotes in the last decade.
Original Article: http://www.gregoryschmidt.ca/writing/apple-event-sept-12-2018
Of of the most important iOS upgrades in years. A strong focus on privacy, security, augmented reality, and de-connecting from social/digital media and reconnecting with people
Original Article http://www.gregoryschmidt.ca/writing/apple-wwdc-june-2018
Bad Blood: Secrets and Lies in a Silicon Valley Startup documents the rise and fall of Theranos. It is a stark reminder of gravity of doing a healthcare startup properly.
Original Article: http://www.gregoryschmidt.ca/writing/bad-blood-book
Innovative elevator button layouts
Original Article: http://www.gregoryschmidt.ca/writing/raised-elevator-buttons
Look outside of America for ways to build better washrooms.
Original Article: http://www.gregoryschmidt.ca/writing/netherlands-washroom-design
The doors in the Netherlands are excellent! It is a design trend I'd like to see imported to America. Original Article: http://www.gregoryschmidt.ca/writing/netherlands-giant-doors
A brief overview of healthcare insurance in America Original article: http://www.gregoryschmidt.ca/writing/hhds07-healthcare-insurance-an-introduction
Long-term care has complex family, resident, and institutional dynamics
Original Article: http://www.gregoryschmidt.ca/writing/hhds06-long-term-care
Nurses have a diverse set of roles in the healthcare system
http://www.gregoryschmidt.ca/writing/hhds05-designing-a-nurse-managed-healthcare-delivery-system
Outpatient medicine is a tough high volume low margin industry.
http://www.gregoryschmidt.ca/writing/hhds04-outpatient-clinics
The VA is the largest provider of direct care in the United States. Its long history is one of controversy and transformation.
Original Article: http://www.gregoryschmidt.ca/writing/hhds03-the-va-healthcare-delivery-system
The Handbook of Healthcare Delivery Systems. Chapter 2 Summary.
The engineering profession can make important contributions to ongoing efforts to make healthcare delivery safe, efficient, patient-centred, timely, and equitable.
Original article: http://www.gregoryschmidt.ca/writing/hhds02-engineering-and-the-healthcare-delivery-system
The Handbook of Healthcare Delivery Systems. Chapter 1 Summary.
The tension of physician autonomy and the desire for medicine to be grey and an art form are contrasted against the trends of science to provide more accurate diagnosis and care delivery structures that do not require physicians at their core.
Original article: http://www.gregoryschmidt.ca/writing/hhds01-healthcare-how-did-we-get-here-and-where-are-we-going
First in a series of chapter summaries on the Handbook of Healthcare Delivery Systems, edited by Yuehwern Yin
Original Article: http://www.gregoryschmidt.ca/writing/handbook-of-healthcare-delivery-systems-index
Ep 14. The user interface designs that lead to accidental audio or video calls
Original Article: http://www.gregoryschmidt.ca/writing/audio-video-call-mixup
Ep 13. Elon Musk’s leaked internal e-mails collected into one place. This post summarizes the leadership and management themes in the emails.
See the original article for the full email collection
Original Article: http://www.gregoryschmidt.ca/the-musk-emails-major-themes
Ep 12. iPhone offers different camera modes. Users should be able to customize this sequence.
Original Article: http://www.gregoryschmidt.ca/writing/customize-iphone-camera-modes
YouTube Version: https://youtu.be/LZfjJ-gpp84
Ep 11. Will participation in full genome sequencing become unavoidable and mandatory?
Full article http://www.gregoryschmidt.ca/writing/mandatory-participation-genome-sequencing
Social media started as an 'optional activity' or luxury, but is participation in social media becoming mandatory. How long will genomic sequencing remain an 'optional' technology?
Part 1: reviews US Gov't proposal to collect social media profiles of VISA applicants.
Original Article: http://www.gregoryschmidt.ca/writing/mandatory-social-media
A red 'record' light means the camera is on. But on Lenovo's monitors it means the camera is off.
Original article: http://www.gregoryschmidt.ca/writing/record-light-mixup
Everyone knows that buying in bulk is cheaper. So why did my friend’s client insist last week that they will pay more to purchase higher volumes of the product/service? Shouldn't it be the other way?
In this atypical contract the buyer pays MORE for purchasing higher volumes, in order to incentivize growth in their supply chain.
Original Article: http://www.gregoryschmidt.ca/writing/catalyst-contracts
Create express lifts by re-assigning some elevators to travel between only two floors. This will raise people faster up the tower closer to their destination as the elevator does not stop at the floors in-between.
For instance, an elevator could stop at Level 1 and Level 12. In order for people to get to their final designation, they can walk up/down the extra stairs.
A four quadrant exercise to map the unintended consequences of machine learning projects
Original Article: http://www.gregoryschmidt.ca/writing/the-four-quadrant-exercise
The 2018 World Economic Forum in Davos has 5.5hrs of healthcare conversations available online.
Original Article: http://www.gregoryschmidt.ca/writing/world-economic-forum-2018-healthcare-videos