What This Blog is About

A long time mentor and friend, Cicely Berry, often says: "all we do comes from our need to survive".

Cis is the Voice Director of The Royal Shakespeare Company. Her profound work and deep appreciation of the human spirit has affected diverse communities all over the world.

Will take you to my current work.

This blog is dedicated to the belief that the overall health of a community or organization is a clear reflection of their ability to communicate.

"Cada cabeza es un mundo" - Cuban proverb

"Every head is a world"

Saturday, August 30, 2008

I've Seen a Real Picture of Change and Almost Missed Something Important

I have not created a post for a while. A project has really taken my attention.

Yesterday, I completed the first edit of a video portrait of health care workers documenting their experience of learning to use Electronic Medical Records (EMR). Asking them questions about the last 18 months at their family practice centers and what's different. The entire project has been an intense team collaboration.

The conversations, responses and stories represent a transformation from thousands of paper charts to a shared information approach that creates a higher level patient experience. It is astounding.

To some organizations who have already adopted these practices, it may seem odd how long it is taking for others to do so.

However, even the most advanced users of EMR understand the need for further connectivity and knowledge sharing across boundaries and practice. It's a continuous improvement commitment. It is also a struggle for funding, board approvals and confronting many of the usual inhibitors to innovation.

I thought I understood why I was so captivated by this project. It's health care, the participants are highly dedicated and I keep learning about their realities and our expectations as patients.

But there was something I missed until I just relaxed and watched the tape this morning.

This is a compelling story of how doctors, nurses, admins and other providers deepened their everyday exchange. The video is a critical visualization of working differently and achieving different results.

The use of EMR (electronic medical records) demands that people work differently to get different results. It gives the patient a way of accessing consistent information across platforms, boundaries and institutions. And, it accelerates the practitioner's professional development.

EMR gives back the ability to highly skilled physicians and practitioners, the time they need to effectively use their skills instead of wasted time in routine or repetitive questioning.

In our current health care environment, we seldom realize how the system inhibits the best abilities of motivated and highly skilled professionals.

Technology to organize and move people from paper to the screen simply accelerates wide cultural change in a way that traditional consulting can never approach.

How many years have we heard about the paperless environment? These workers take it to a new level of commitment. One patient, one chart. Anywhere, anytime. That is their goal.

Health care workers are always driven by complexity, urgency and humanity.

Understanding the value of EMR is a revelation when you see and hear it from the communities of practice and need. The example should inform all of our business perspectives.

All the issues of privacy (which are most manageable) or concerns about less personal do not come close to seeing patients understanding their own situation more clearly than ever before.

And, the truth about medicine moving to a collaboration becomes exciting within the context of information when you and your health care providers need it. We all have more than one doctor and we seldom connect them to solve our issues quickly and safely.

I cannot do justice here of what I learned from creating this video. Please understand, I use video as data collection. Not typical corporate support material.

But I can say, much of the theory and experience that frameworks large scale business transformation and organization design goes out the window when a doctor describes how a patient who cannot read, now understands their current health state for the first time. The graphic display on the screen with the patient's test results etc. is viewed and discussed with the doctor.

Such an encounter maps a network of change from the doctor's activity to everyone who contributes to this technology that unites them.

I realized this morning, that this example is a poignant metaphor for much of what I have encountered with large organizations. Years of discussing change without the ability to clearly read and act.

For the health care professionals who have given me this incredible experience, I can only say thank you. And, I can continue to learn what their transformation means for all our work place transformations.