Thursday, May 14, 2009

SmartForms : An Ambulatory Clinical Decision Support Tool

Since 2005, I have had the privilege to work with some of the best minds behind healthcare best practices in the US. Folks like Dr. Tejal Gandhi, Dr. David Bates, Dr. Blackford Middleton, John Glaser and others have given me the opportunity to create and work on systems that think beyond traditional models of care delivery.

SmartForm is a outpatient point-of-care application that is able to deliver cross-disease specific clinical decision support on a single modality to improve and measure outcomes. In English, it means a platform that displays everything you might want to know proactively as a physician to deliver cost-effective, efficient and collaborative treatment of all the conditions a patient presents, without compromising patient contact time.


Here's a recent JAMIA article authored by my colleagues talking about this application.


Over the years, I have learnt to appreciate the fact that it is difficult and somewhat impossible, at least during my generation, to replicate scientifically how physicians practice medicine. Healthcare IT's 'pixie dust' promise to save billions of dollars, avoid negligent care and improve access issues has its limitations. I am not yet convinced IT is the primary answer to the healthcare issues we face as a country. But whatever we can and have done so far, seem to result in a positive dialogue at the doctors office.

This confidence goes a long way and gives all of us hope that one day, we might just be able to perfect the art of medicine. Until then, I will still be in awe of doctors doing God's work.


Read more! Link

Tuesday, May 12, 2009

What The Recession Did For me

I have seen 4 recessions in my life. 2 of them during my working career. The last one in early 2000's proved to be incredibly volatile and we all thought doom & gloom but it was one of the best things that ever happened to me.

I made almost half of what I did before the crash of 2000. My investors backed out of commitments and I was forced into an involuntary liquidity event. I was laid off multiple times - sorry - 'rationalized' from CMGI & 'realigned' from AT&T. 80% of my network had lost their jobs. Everyone I knew, including myself, was in a constant state of panic and urgency. As the Internet House-of-Cards collapsed in front of us, it seemed as if the world was about to end. It separated the men from boys.

Being in this situation made me humble and made me realize the need for creating and sustaining tangible value. Value not only in the business world but also personally.

Was what I did (spend) measurable and meaningful? Was the benefit I received from doing something long term or short term sustainable? How am I displaying my benefit (by being happy, making others happy, elevated, at peace, etc or a combination of one or more of such feelings)? Why was I doing something? (to substitute something else, to fill a gap, to spend time, to replace something that I currently don't have, to make myself feel valuable, etc) and lastly - how do I want to be remembered?

As a result, I realized what was truly important and how indifferent I could be towards certain material aspects of my life that once seemed 'essentials'. Very philosophical you say but it made me a different person than who I was pre-2000.

Though I am not in a position I was almost a decade ago, the current recession does remind me the tough times me and many others faced. I realize what I should and should not be doing. The following are some decisions I made that I personally felt were a "waste" and did not hold value for me anymore.
  1. Food: If you follow me on http://www.yelp.com/, you probably know that food is in my DNA. Especially eclectic food from famous chefs. I no longer go to fancy restaurants unless it is warranted by an anniversary or a very special occassion. I discovered that the joys of cooking at home with your better half is equally if not more appealing. I also plan to hire a chef that can deliver several dishes for a week at about 1/3rd the cost of one meal at L'Espalier. I will also no longer eat at chain eateries like Crazy Dough ($4 for a slice of pizza - get real), Boccolo ($7 for a Burrito - no way José), Pete's Coffee (wannabe Starbucks), Subway (quality is getting atrocious). I will also no longer eat at places that refuse to recognize me with discounts or promotions as a repeat customer of many years. And I strongly feel that places like Whole Foods (more like Whole Pay-check) and Bread & Circus are overrated and over-priced. Organic is an overused word that is meaningless for folks like me who grew up in India where everything is organic anyways. There is no real concept of growth hormones even till date.
  2. Clothing: Most of the clothes you get at Bloomingdale's, Saks or Needless Markups (Neiman Marcus) are made in India, Israel, Egypt, China and Italy. I decided I would either change my name to some random Italian name or stick an pseudo-Italian sounding word to my trousers if I really wanted to feel couture! I also realized that I don't need a "walk-in-closet". That concept does not even exist outside the US and had been bothering me. I need no more than 5 trousers and no more than 10 shirts for work. And they should all match with each other. That's 50 different combinations. There was a time in my life where clothes defined me. Today - its what I stand for and what I have to say that defines me. I truely feel free.
  3. Transport: Unfortunately, cars are a way of life in America. Even in the cities. That equation is no longer sustainable and has to change. It already is in many ways! In December, my car of 10 years broke down and I decided to forego my intentions to buy a German performance car. It was a tough decision (think Maya). I decided I needed a transport vehicle. Acceleration, speed, amenities that I have to remember to use and degrading the environment was not necessary. I bought a Corolla. I felt free and $30,000 richer. A hundred years from now, I don't think our conscience will allow us to drive the vehicles of today and behave the way we do. Why not start that trend today? The key word is efficiency and effectiveness. Give me a 1 person 'pod' that runs on ethanol anyday compared to a BMW M Series or an Aston Martin. It's shameful that we as a race still believe in making transport vehicles that burn more resources (fuel) that take a million+ years to make. It's like being irresponsible parents.

There are many other small areas where I see myself chaging (not using the word cutting back). So in many ways, recession is good. It makes us realize the true value and need behind everything we own, everything we do and what really matters to us.

If anyone has seen any episode of Star Wars or Star Trek, the housing pods that people live in don't seem to have a lot in them except the necessities. And the characters seem to engage in a conversation and interaction rather than hoarding 'stuff'. There is some truth to that representation.

Less is more. Simplicity is key to free your mind from distractions. Free yourself and see how good you feel.

I am not promoting capitalism today. My apologies to hose who expected to read about debt financing and valuations.


Read more! Link
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