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The bright side of sitting in traffic: Crowdsourcing road congestion data

This post is the latest in an ongoing <a href="http://googleblog.blogspot.com/2008/11/how-we-help-track-flu-trends.html">series</a> about how we harness the data we collect to improve our products and services for our users. - Ed. What if you could do a little something to improve the world during your daily drive to work? Here are a few ideas: tell everybody in the city when you're stuck in slow-moving traffic; warn the drivers on the freeway behind you that they should consider an alternate route; tell the people still at home that they should spend another ten minutes reading the morning news before they leave for work; tell your city government that they might want to change the timing of that traffic light at the highway on-ramp. Of course, you can't just get on the phone and call everybody, and your one traffic report from your one spot on the road might not help much anyway. But if everybody on the road, all at once, could tell the world how fast their car is moving, and we could make it easy for anybody to check that information on their computer or cell phone, well — then we'd be getting somewhere. If you use <a href="http://www.google.com/mobile/products/maps.html">Google Maps for mobile</a> with GPS enabled on your phone, that's exactly what you can do. When you choose to enable Google Maps with <a href="http://www.google.com/mobile/gmm/mylocation/index.html">My Location</a>, your phone sends anonymous bits of data back to Google describing how fast you're moving. When we combine your speed with the speed of other phones on the road, across thousands of phones moving around a city at any given time, we can get a pretty good picture of live traffic conditions. We continuously combine this data and send it back to you for free in the Google Maps traffic layers. It takes almost zero effort on your part — just turn on Google Maps for mobile before starting your car — and the more people that participate, the better the resulting traffic reports get for everybody. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-qXddE05UTfYPov7sSX0DE7xKCi9UpLrhx-ge43mxq2kk0RWM9eACvwlPPZWdHPXTrn8ZyZxKUAS2DC4EvuC1q0KEfFWj5G0aqKYWuZW8iLaZRq4YGAV39zj84WJe1O4_HgCUXBnMav1q/s1600-h/gmm_arterials_z15.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5373770641888093074" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-qXddE05UTfYPov7sSX0DE7xKCi9UpLrhx-ge43mxq2kk0RWM9eACvwlPPZWdHPXTrn8ZyZxKUAS2DC4EvuC1q0KEfFWj5G0aqKYWuZW8iLaZRq4YGAV39zj84WJe1O4_HgCUXBnMav1q/s400/gmm_arterials_z15.png" style="cursor: pointer; display: block; height: 400px; margin: 0px auto 10px; text-align: center; width: 267px;" /></a> This week we're<a href="http://google-latlong.blogspot.com/2009/08/arterial-traffic-available-on-google.html"> expanding our traffic layer</a> to cover all U.S. highways and arterials when data is available. We're able to do this thanks in no small part to the data contributed by our users. This is exactly the kind of technology that we love at Google because it's so easy for a single person to help out, but can be incredibly powerful when a lot of people use it together. Imagine if you knew the exact traffic speed on every road in the city — every intersection, backstreet and freeway on-ramp — and how that would affect the way you drive, help the environment and impact the way our government makes road planning decisions. This idea, which we geeks call "crowdsourcing," isn't new. Ever since GPS location started coming to mainstream devices, people have been thinking of ways to use it to figure out how fast the traffic is moving. But for us to really make it work, we had to solve problems of scale (because you can't get useful traffic results until you have a LOT of devices reporting their speeds) and privacy (because we don't want anybody to be able to analyze Google's traffic data to see the movement of a particular phone, even when that phone is completely anonymous). We achieve scale by making Google Maps for mobile easy to install and use, and by making it easy for people to provide information about their own vehicle speed. There's no extra device to plug into your car and no extra software to buy. Google Maps is <a href="http://www.google.com/mobile/default/maps.html">free</a> and works with most cell phones, and the number of cell phones with GPS is rising every day. Some phones, such as the T-Mobile myTouch 3G and the Palm Pre, come with Google Maps and traffic crowdsourcing pre-installed (the iPhone Maps application, however, does not support traffic crowdsourcing). Google is fortunate to have a lot of people using our products, and that scale helps make our products better. We understand that many people would be concerned about telling the world how fast their car was moving if they also had to tell the world where they were going, so we built privacy protections in from the start. We only use anonymous speed and location information to calculate traffic conditions, and only do so when you have chosen to enable location services on your phone. We use our scale to provide further privacy protection: When a lot of people are reporting data from the same area, we combine their data together to make it hard to tell one phone from another. Even though the vehicle carrying a phone is anonymous, we don't want anybody to be able to find out where that anonymous vehicle came from or where it went — so we find the start and end points of every trip and permanently delete that data so that even Google ceases to have access to it. We take the privacy concerns related to user location data seriously, and have worked hard to protect the privacy of users who share this data — but we still understand that not everybody will want to participate. If you'd like to stop your phone from sending anonymous location data back to Google, you can find opt-out instructions <a href="http://support.google.com/gmm/bin/answer.py?hl=en&answer=81875">here</a>. We've already been able to provide useful traffic information with the help of our existing mobile users, but we hope that is just the start. As GPS-enabled phones and data plans get less expensive, more people will be able to participate. Crowdsourcing traffic gives us a way to harness bits of location data from our users and give it back to them in a form they can use to make impactful decisions that affect their free time, their pocketbooks and the environment. The more people use it, the better it will get. So next time you're sitting in morning traffic, turn on Google Maps for mobile and let someone else know they can hit the snooze button one more time. Tomorrow morning, they might do the same for you. Posted by Dave Barth, Product Manager for Google Maps

The bright side of sitting in traffic: Crowdsourcing road congestion data

This post is the latest in an ongoing series about how we harness the data we collect to improve our products and services for our users. -...

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H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations

A somewhat remarkable new book will be released in Nov. 2009 by the American Health Information Management Association (<a href="http://www.ahima.org/">AHIMA</a>), of which I am an associate editor. It is aimed largely at IT and healthcare management personnel who are not knowledgeable in Medical Informatics. I express thanks to AHIMA for their forward thinking in accepting and publishing this material. Books such as this were difficult to get into print just a few years ago, likely due to resistance to their publication by the powerful trade organizations of the health IT vendors: <blockquote><a href="https://www.ahimastore.org/ProductDetailBooks.aspx?ProductID=14181">H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations</a> In H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations, the editors—all of whom have led successful electronic health record (EHR) and Health Information Technology (HIT) projects—have collected case studies of HIT implementations that didn't go as planned, offering expert insight into key obstacles that must be overcome to leverage IT and modernize and transform healthcare. ... the adoption of effective HIT—now a national priority with the passing of President Obama's American Recovery and Reinvestment Act of 2009 (ARRA)—remains at a fairly primitive stage compared with IT adoption in every other major industry. In fact, healthcare is the only trillion dollar industry that remains primarily in the paper stage, even though most healthcare data are available electronically. By studying HIT implementations that failed, the editors are able to document, catalogue, and share key lessons that all project managers of HIT, health system leaders in informatics and technology, hospital executives, policy makers, and service and technology providers must learn in order to succeed with HIT. H.I.T. or Miss presents a model to discuss HIT failures in a safe and protected manner, providing an opportunity to focus on the lessons offered by a failed initiative as opposed to worrying about potential retribution for exposing a project as having failed. Authors The editor and associate editors all served on the 2007 leadership board of the Clinical Information Systems Working Group of the American Medical informatics Association (AMIA). Editor: Jonathan Leviss, MD Associate Editors: Brian Gugerty, DNS, MS, RN Bonnie Kaplan, PhD Gail Keenan, PhD, RN Jonathan Leviss, MD Larry Ozeran, MD Eric Rose, MD Scot Silverstein, MD </blockquote> This book follows the anonymized case study approach I used in my <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/medinfo.htm">website on HIT difficulties</a>, started in 1999, itself based loosely on the style of the introduction of the 1994 book "<a href="http://www.amazon.com/Managing-Technological-Change-Organizational-Informatics/dp/0387985484">Managing Technological Change: Organizational Issues in Healthcare Informatics</a>" (ed. 1) by sociotechnical issues pioneers informaticists Nancy Lorenzi and Robert Riley. One can talk about "healthcare transformation" via HIT all one wants, but until the current inadequate approaches to HIT (per the <a href="http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12572">National Research Council, 2009</a>) are themselves transformed, doing so is largely wide-eyed utopianism. I am quite pleased to see this new book appear. (Note: I will not receive any royalties for sales). -- SS

H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations

A somewhat remarkable new book will be released in Nov. 2009 by the American Health Information Management Association ( AHIMA ), of which I...

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NY Mayor: Pharmaceutical Executives "Don't Make a Lot of Money"

We just posted about the onrush of people into health care management, including many with little knowledge of or experience in health care. <a href="http://www.google.com/hostednews/ap/article/ALeqM5iIDQ_Nf9xpv7MZj2NNu9PsxfAAxwD9A7DOKO2">According to the Associated Press</a>, one prominent politician defended at least pharmaceutical company managers who "don't make a lot of money." [Warning, irony and sarcasm ahead.] <blockquote> Billionaire Mayor Michael Bloomberg defended multibillion-dollar pharmaceutical companies and their chief executives on Friday, declaring that they 'don't make a lot of money' and shouldn't be scapegoats in the health care debate. The mayor — and wealthiest person in New York City with a fortune estimated at $16.5 billion — made the comments on his radio show Friday during a discussion about health care. "You know, last time I checked, pharmaceutical companies don't make a lot of money, their executives don't make a lot of money — not that they couldn't be better," Bloomberg said. The mayor, a Republican-turned-independent who already has spent more than $36 million on his re-election campaign this year, often battles criticism that he is out of touch with regular people. He built his fortune after founding the financial information company that bears his name. Earlier this year he declared "we love the rich people" while arguing against raising taxes on the wealthy, and said recently that President Barack Obama, who earns $400,000 a year and has made millions from book sales, "doesn't get paid that much" and is "on a budget" like millions of Americans. </blockquote> In its article on the Mayor's health care wisdom, the NY Daily News noted, <blockquote> The highest-paid drug executive last year, Johnson & Johnson CEO Bill Weldon, took home a reported $29.4 million after his company raked in $63.7 billion. </blockquote> The Associated Press article also commented, <blockquote> Pharmaceutical CEOs are known to make millions, with generous salaries, stock options and other perks. Abbott Laboratories Inc. Chairman and Chief Executive Miles White's compensation was $25.3 million in 2008. The North Chicago, Ill.-based company saw profit rising 35 percent to $4.88 billion. Merck & Co.'s chief executive, Richard T. Clark, received a $17.3 million compensation package for 2008. The company's profit more than doubled to $7.8 billion. </blockquote> Later, <blockquote> It was clear that Bloomberg or one of his aides realized his gaffe while he was still on the air Friday. The mayor, who has sought to cast himself as a financial and business expert, came back from a break and said he had looked up the pay of some pharmaceutical executives. 'Some of them are making a decent amount, more than a decent amount of money,' he said. Either way, Bloomberg said, it doesn't solve anything to beat up on pharmaceutical companies while trying to come up with health care solutions. </blockquote> We have previously posted about the notion that the US and the rest of the world is increasingly run by members of the "<a href="http://hcrenewal.blogspot.com/search/label/superclass">superclass</a>," whose disconnection from the realities of daily life, including the US dysfunctional health care is likely to translate into little real support by the powers that be for meaningful health care reform. Mayor Bloomberg's wealth and political power would qualify him for superclass membership. His notion that multi-million dollar a year pharmaceutical imperial CEOs ought to be pitied for their paltry incomes suggests not only that the very rich are unlike you and me, but that meaningful health care reform is unlikely as long as we allow ourselves to be lead by people so insulated from the vicissitudes of daily life.

NY Mayor: Pharmaceutical Executives "Don't Make a Lot of Money"

We just posted about the onrush of people into health care management, including many with little knowledge of or experience in health care....

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NY Times Proclaims Anyone Can Run a Health Care Organization "with a Little Studying Up"

Last week, the NY Times published a somewhat breathless <a href="http://www.nytimes.com/2009/08/20/education/20HEALTH.html">article</a> on the wonderful opportunities available in health care management. Health care management seems to be the one area that is growing during the "great recession." <blockquote>Health care may be a costly drag on the economy, but it’s still a great place to find a job. Midcareer managers and other workers have been migrating to health care jobs for years, of course. Now, with the recession, the lure is even stronger. </blockquote> The article suggested managing health care organizations does not require knowing much about health care. <blockquote> 'The demand for talented leaders in health care is only going to go up,' predicted Jane Groves, a senior vice president at Integrated Healthcare Strategies, an executive search and consulting firm in Kansas City, Mo. 'All that demand can’t and shouldn’t be filled by people already working in health care.' </blockquote> The article supplied success stories of health care managers who came from unrelated fields, without any actual experience giving care, or knowledge of biomedicine. For example, <blockquote> Frank Pinkowsky worked as a manager at DuPont for 24 years before taking a position as senior vice president for human resources at the Guthrie Clinic in Sayre, Pa. 'Don’t underestimate the value of what you learned working for someone else,' he advised. </blockquote> Also, <blockquote> 'We just recently recruited a vice president for human resources from the supermarket industry,' said Mike A. Helm, a senior executive at Sutter Health, a hospital chain with 45,000 employees in Northern California. Sutter hires 20 to 30 executives a year. </blockquote> At most, becoming a top healthcare executive only requires some course-work on health care management, perhaps on-line rather than in a classroom. Again, no real experience giving care, or knowledge of medicine or biology is required. For example, <blockquote> Colin Ward, a 37-year-old Baltimore hospital executive, also successfully switched careers, leaving ESPN after eight years of producing sports broadcasts. 'I felt like I wanted to be contributing in some other way,' he said. After 11 months of graduate classes in the Johns Hopkins Bloomberg School of Public Health and a year as a paid apprentice at a Baltimore hospital, he had a master’s degree in health science and management. Mr. Ward stayed at the hospital, Lifebridge Health, for three more years and in 2007 moved to his current post at the Greater Baltimore Medical Center in Towson, Md., as director of corporate strategy. </blockquote> In general, <blockquote> Many managers with experience in fields like human resources, finance and marketing find a welcome in health care, with a little studying up. Online courses, books, journals and professional magazines provide material. </blockquote> The article argued that managing health care information technology also does not require any real knowledge of actual health care. <blockquote> The Obama administration’s $19 billion 10-year campaign to promote electronic medical records opens another huge opportunity, said Dr. Blackford Middleton, a technology research expert at Partners Healthcare in Boston. An estimated 40,000 to 160,000 additional health information professionals could be needed, he said. The industry trade association, known as Himss [sic] for the Healthcare Information and Management Systems Society, offers an array of online courses that can help technology workers move into health care. </blockquote> The article did allow <blockquote> Health care does, of course, have its own jargon and a host of complex challenges. Managers have to know how to deal with doctors, nurses and professional groups, as well as with regulators. </blockquote> But perish the thought that health care executives who have to deal with lesser species like doctors, nurses and other professionals have to understand much about what these lowly folks actually do. Somehow, the lessons from the bankrupt automobile companies led by executives with business degrees but no real knowledge of or interest in automobiles and how they are made, and from failed finance companies which sold complex financial derivatives that their executives did not understand do not seem to obtain. It does all have a certain degenerate, bubble about to burst odor. The notion is the health care boom is so intense that anyone can run a health care organization. We did find out that anyone can run an automobile company or finance firm too. The results just may not be so pretty. Is it any wonder that in this climate, people with no understanding of the health care mission are running health care organizations, and soon the organizations are run in conflict with that mission? As we have said before, to really reform health care, we need health care leaders who actually understand health care, and support its values. But the bubble may have to burst before many people learn that lesson. For now, there is too much money to be made.

NY Times Proclaims Anyone Can Run a Health Care Organization "with a Little Studying Up"

Last week, the NY Times published a somewhat breathless article on the wonderful opportunities available in health care management. Health ...

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WellCare "Did Not Contest" that its Political Contributions Violated State Law

From a <a href="http://blogs.tampabay.com/buzz/2009/08/huge-fine-levied-over-dubious-campaign-donations.html">report</a> in the St Petersburg (Florida) Times: <blockquote> WellCare Health Plans on Wednesday admitted to making 129 'questionable' contributions to Florida politicians over four years ending in 2007. In a consent order with the Florida Elections Commission, the Tampa-based managed-care company agreed to pay a $120,000 fine and did not contest the commission's finding of probable cause that the contributions violated state law. The Associated Press reported in February that WellCare, its subsidiaries and executives spent $2.4 million in political contributions in the 2004 and 2006 elections. More than 95 percent went to Republicans, who pushed a plan to send more state and federal Medicaid spending through private companies like WellCare. </blockquote> In May, 2009 we <a href="http://hcrenewal.blogspot.com/2009/05/wellcare-settles-accepts-deferred.html">posted</a> about WellCare's submission to a deferred prosecution agreemeent based on charges that it defrauded state programs by inflating its expenses. In 2007, we <a href="http://hcrenewal.blogspot.com/2007/11/health-plans-programs-cancelled-for.html">posted</a> about how the state of Connecticut stopped WellCare from running a plan for poor children after the company refused to reveal what it was paying physicians, and why it was failing to pay for particular services. So WellCare has paid three penalties for three different kinds of unethical behavior in the last two years. WellCare is one of numerous health care organizations which seem to be serial violators of reasonable ethical norms. Usually, however, the penalties paid for these behaviors are trivial, given the financial capacities of the offending organizations. Furthermore, rarely are the individuals who made the decisions that caused the behaviors identified, much less subjected to negative consequences. Given our continued permissiveness towards all sorts of deception, dishonesty, cheating, and even outright fraud, bribery, and corruption, is it any wonder that the unethical behavior continues? Such behavior doubtless directly drives up costs. Furthermore, leaders focused on their personal power and enrichment may not lead well, and demoralize employees and professionals who want to do the right thing, leading to further cost increases, access decrements, and threats to health care quality. I submit that to truly reform health care, and have a chance at improving cost, quality, and access, we cannot continue to shrug off these sorts of ethical violations. A postscript - as we have noted before, one member of the <a href="http://ir.wellcare.com/phoenix.zhtml?c=176521&p=irol-govboard">WellCare board of directors </a>is Regina Herzlinger, a well known and prolific health policy expert, and holds the <a href="http://drfd.hbs.edu/fit/public/facultyInfo.do?facInfo=bio&facEmId=rherzlinger">Nancy R. McPherson Professor of Business Administration Chair of the Harvard Business School</a>. As far as I know, Prof Herzlinger is one of the many health policy experts who avoids discussing the sorts of problems with the accountability, integrity, and transparency of health care leadership which is grist for the mill here at Health Care Renewal. Perhaps, Prof Herzlinger, like many other main stream health policy experts, should learn to acknowledge that health care leadership may be unaccountable, opaque, dishonest, and sometimes flagrantly corrupt. Furthermore, Prof Herzlinger, like many other well-paid board members of health care organization, should pay a bit more attention to the mischief being committed by those who answer to her.

WellCare "Did Not Contest" that its Political Contributions Violated State Law

From a report in the St Petersburg (Florida) Times: WellCare Health Plans on Wednesday admitted to making 129 'questionable' contri...

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Another Haunting Tale

Halloween is more than two months away, but the ghost stories just keep on coming. The latest version was <a href="http://www.google.com/hostednews/ap/article/ALeqM5iUKEK0btRTAsKW5IDK5GtDQz_DWQD9A669802">reported</a> by the Associated Press (with a hat tip to Prof Margaret Soltan <a href="http://www.margaretsoltan.com/?p=16497">on the University Diaries blog</a>). To quickly summarize, <blockquote> Drugmaker GlaxoSmithKline used a sophisticated ghostwriting program to promote its antidepressant Paxil, allowing doctors to take credit for medical journal articles mainly written by company consultants, according to court documents obtained by The Associated Press. An internal company memo instructs salespeople to approach physicians and offer to help them write and publish articles about their positive experiences prescribing the drug. Known as the CASPPER program, the paper explains how the company can help physicians with everything from 'developing a topic,' to 'submitting the manuscript for publication.' </blockquote> The actual document is now available from the PharmaGossip blog <a href="http://pharmagossip.blogspot.com/2009/08/gsk-paxil-caspper-read-file-for.html">here</a>. Reviewing that document suggests that the CASPPER program was a bit different from other ghost-writing schemes (for example, see previous posts <a href="http://hcrenewal.blogspot.com/search/label/ghost%20writing">here</a>.) A typical ghost-writing scheme would entail ghost-writers employed by a medical education and communications company (MECC) drafting manuscripts of a scholarly-appearing review articles. The articles would be written to support the marketing of a product made by the (usually pharmaceutical) company which hired the MECC. Then, the MECC would recruit well-known medical academics as (guest) authors for the articles. The guest authors might make some minor revisions in the draft manuscripts, which would then be submitted to scholarly journals. The MECCs would handle the submission process, while maintaining the pretense that the articles were the work of the guest academic authors. The ultimate purpose of such schemes apparently would be to market the product in the guise of scholarly publication. CASSPER, on the other hand, was meant to produce more modest articles, ostensibly written by practicing, rather than purely academic physicians. Review of the CASSPER document leads to some interesting conclusions about the project - The project was purely a marketing project. "The objectives of CASSPER, from a publication standpoint, are to strengthen the product positioning and overcome competitive issues." The document clearly was written by marketers, and directed to pharmaceutical representatives ("drug reps.") It did not mention any involvement by GSK scientific or medical personnel. The closest it came to making a pretense about any scientific or clinical usefulness of the project was, "publication of such articles will benefit the sales force by expanding the database of published data to support PAXIL." - It was as much about promoting closer relationships among pharmaceutical representatives ("drug reps") and doctors as about publishing articles. The project was to be implemented by drug reps, and "your participation will establish and/or strengthen your relationships with key physicians and thought leaders in the psychiatric field." The drug reps would handle, and presumably shape all communications between their physicians and the MECC. - Articles were to arise from instigation by the drug reps, rather than from physicians' initiatives. For example, a scenario for recruiting authors began, "a physician tells you that he or she has had treatment success with PAXIL in certain indications or difficult-to-treat patient populations." Then, "ask the physician if any consideration has been given to publishing a case study based on this clinical experience." - Although the document is somewhat ambiguous about the role of the putative author in the process, an extensive list of services available from the MECC (Complete Healthcare Communications [CHC] ) would have left little for the author to do. "The full range of editorial assistance that CASSPER can offer contributing physicians includes: developing a topic, coordinating the editorial review process, submitting to the target journal." The company's role would include "coordinating" manuscript preparation, which was defined as "development of an outline and first draft, editorial reviews, and revisions." The company would make available "published literature, available internal support, literature search results, and a database of journal submission criteria." Also, "the numerous details that CHC is prepared to coordinate ... [include] copy editing and proofreading, production of tables and graphics, preparation of the submission package, and follow-up." So CASSPER seems to be a not really so friendly example of a newly recognized species of ghost-writing, targeted more at promoting relationships among drug reps and physicians than at producing ostensibly scholarly articles. Nonetheless, this example of the haunting of medicine is as fundamentally deceptive as previously described ghost-writing schemes. In the CASSPER project, physicians would be reduced to little more than ectoplasm, goaded by drug reps into token involvement in a writing process exclusively handled by the MECC, and mediated by the friendly appearing drug reps. I wonder whether physicians who participated escaped with any psychological independence from the drug reps who magically turned them into acclaimed "published authors?" In any case, the disclosure of CASSPER, a ghost who was friendly only in appearance, adds more evidence about how deception and dishonesty now haunts our health care system. To achieve real health care reform, we will have to find a new group of ghost-busters. Who you gonnna call? ADDENDUM (25 August, 2009) - See also<a href="http://brodyhooked.blogspot.com/2009/08/friendly-ghosts-why-should-academic.html"> comments </a>by Dr Howard Brody in the Hooked: Ethics, Medicine and Pharma Blog.

Another Haunting Tale

Halloween is more than two months away, but the ghost stories just keep on coming. The latest version was reported by the Associated Press ...

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Why Siemens Healthcare Fails

I have written <a href="http://hcrenewal.blogspot.com/search?q=don%27t+need+informatics">numerous times on this blog</a> about the blind-man ignorance displayed by many healthcare IT and biomedical companies regarding Medical Informatics expertise. As a graduate and postdoctoral-level <a href="http://www.ischool.drexel.edu/faculty/ssilverstein/failurecases">Medical Informatics educator</a> with considerable applied expertise, as well as talent management experience, I teach students of a variety of healthcare backgrounds that the only way to overcome the sociotechnical complexities (i.e., issues at the intersection of people and their interaction with technology) of HIT is via education and considerable experience. Once students become aware of the nuances and complexities of HIT in real-world clinical settings (if not already enmeshed in such environments), they find the lessons learned from substantial and rigorous immersion into a wide corpus of literature, overseen by someone with expertise, profoundly important towards advising their own organizations in avoiding pitfalls and achieving success. I note that I used to admire German engineering rigor, but after seeing ill conceived, misguided position ads like the following from Siemens Healthcare, I am having sincere doubts about that country's current prowess in that domain. I refer to a recent ad (<a href="https://careers.peopleclick.com/careerscp/client_siemens/external/jobDetails.do?functionName=getJobDetail&jobPostId=288315&localeCode=en-us&source=Indeed&sourceType=PREMIUM_POST_SITE">here</a> at the moment) for a Physician Consultant: <blockquote>Job Description Siemens Medical Solutions is the industry leader in Healthcare IT technology and Clinical workflow solutions. We are seeking to hire an experienced Physician for our Professional Consulting Services Organization. In this highly visibly position, you will support the implementation of Siemens products (such as Soarian ) in hospitals nationwide. To be considered for this position, qualified candidates must have the following credentials and experience: • U.S. based Medical degree with at least five years of post-residency experience in large multi-specialty practice or hospital-based facility in the United States. • Currently practicing medicine, or must have practiced at least 1 week per month within the last 3 years • Leadership experience with at least one CPOE implementation in a large, multi-facility health system, Integrated Delivery Network (IDN) setting • Extensive public-speaking and executive presentation experience • Medical informatics credentials or advanced degree preferred, but not required [Medical Informatics not required? - ed.] • Prefer some experience in public-health related projects</blockquote> Here are the obvious major problems: One CPOE implementation or even several does not by any means qualify a person to counsel other medical organizations and clinicians as a representative of a company citing itself as "the industry leader in Healthcare IT technology." Further, the criteria "Medical informatics credentials or advanced degree preferred, but not required" suggests the crafters knows little about Medical Informatics, or hold it at a low level of esteem, considering it an optional "gift" that might add slight extra value to the incumbent's ability to travel the country and give good advice and support in clinical IT implementation. What might substitute for such knowledge and expertise? This J.D. might better be described as "glorified salesperson." It might be a good exit route for a "techie doc" (usually, someone who knows just enough about HIT to be destructive) who hates the current practice environment. It might also be good for managers who don't want knowledgeable experts pointing out their bad decisions and mismanagement, but I think a global company like Siemens should be setting its sights higher in such a crucial area as electronic medical records and clinical IT consultants. I would not want such a physician advising or supporting complex HIT projects at my organization. I spent time at Siemens Healthcare headquarters in Erlangen in 2000, and was offered gracious hospitality and a position overseeing the Soarian cardiology suite. The people I met in Erlangen then seemed extremely competent and informatics-savvy, but I turned the offer down through no fault of Siemens. I'd received a near-simultaneous offer (FAXed to my hotel in Erlangen, in fact) from pharma that involved a much stronger management role. I understand through conversations over the past few years with current and ex-Siemens personnel that most of the Siemens personnel I'd met in Germany in 2000 are no longer with the company. I was told they'd performed suboptimally after the acquisition/merger with Shared Medical Systems (SMS) in Malvern, PA. (I do not find that credible, and would find it far easier to accept that the problems were on the American side, but that is a personal opinion.) Questions raised by these observations: <ul><li>What manner of ideology about education and expertise does this job description represent?</li></ul><ul><li>Is there nobody left in Germany with a realistic sense of the education and expertise required to advise on and support HIT implementations in a competent manner, I ask? </li></ul> Allow me to answer question #1. It represents the IT designer-centric, data processing and <a href="http://hcrenewal.blogspot.com/2008/05/seedie-society-for-exorbitantly.html">tabulator punch card culture-based</a> (and antithetical to medicine and science) view that with enough generalists and sufficient "process", any problem can be solved. By this logic, Bach and Beethoven would have had symphonies written for them by low level musicians in the name of "efficiency" and cost savings. <div style="TEXT-ALIGN: center"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEix2PJZV6Lvz941B1K1MCZDOWpErm3UXImudOHfJVWl5yuX37hFPCy8cN8OlzhDqFnkSyN-g1ERPUCryj_HrM6HT1IB7bHzS5IowuLcYMSWtcAJMDZ-Loyp9s2R8SDwrUijd9Yq2ZqICcv1/s1600-h/Beethoven.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5373145108395395298" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEix2PJZV6Lvz941B1K1MCZDOWpErm3UXImudOHfJVWl5yuX37hFPCy8cN8OlzhDqFnkSyN-g1ERPUCryj_HrM6HT1IB7bHzS5IowuLcYMSWtcAJMDZ-Loyp9s2R8SDwrUijd9Yq2ZqICcv1/s320/Beethoven.jpg" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 129px; CURSOR: pointer; HEIGHT: 156px; TEXT-ALIGN: center" /></a> Wanted: consultants to write my Ninth Symphony, according to the Acme Symphony-Writing Process Manual. Musical experience not essential. Must be team players. </div> Shareholders, take note. I emailed this post to the Siemens Healthcare CEO Hermann Requardt, who I note (almost predictably) <a href="http://w1.siemens.com/about/en/management-structure.htm">lacks a biomedical background</a> other than having been a research assistant for aviation medicine once, and having worked on MRI: <div class="p clearfix"></div><blockquote><div class="p clearfix">Education </div><div class="list"><ul class="bullet-list-orange"><li>Secondary school (baccalaureate)</li><li>Studied physics at the Technical University of Darmstadt and University of Frankfurt (Dr. phil. nat., Dipl.-Phys.)</li></ul></div></blockquote><div class="list"> A lack of response is therefore not surprising. </div>-- SS

Why Siemens Healthcare Fails

I have written numerous times on this blog about the blind-man ignorance displayed by many healthcare IT and biomedical companies regarding...

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