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Cannot Get Away From Medical Information Errors, Continued

In "<a href="http://hcrenewal.blogspot.com/2007/10/this-informaticist-cant-escape-clinical.html">This informaticist can't escape clinical IT issues even on personal business</a>", I observed that I encountered HIT informational issues even in my own family matters, when least expecting them. I've had a few incidents since then, generally each time I've taken relatives to the hospital as a medical advocate. It seems every time I step into a hospital as a medical advocate such issues arise, whether they be complaints from staff about IT, my mother being prescribed an IV antibiotic in the ED that an hour before I'd told the intake nurse she was severely allergic to, that fact being dutifully entered into the EHR - or as in the case below, outright errors regarding surgical procedures. Either medical information errors follow me around, or they are more common than I realize, because I just spent a few days as a medical advocate for a very long and dear friend. She had a suspicious thyroid nodule found at the time of exam for excision of a small breast carcinoma. She was set to have a thyroidectomy at a major NYC hospital with relatively advanced HIT capabilities and large endowments from very wealthy contributors, whose paintings hang in the lobbies (and where some high level informatics professionals are involved in clinical IT projects). When I arrived the evening prior to surgery, my friend showed me her pre-op instructions. They were printed out in a neat and organized fashion, and she'd shown me the calcium supplements she'd purchased as the instructions advised. "Calcium supplements?", I asked... The computer form, properly labeled with her name and ID and the name of the nurse practitioner she'd seen for preop evaluation, was quite improperly entitled "Preoperative instructions to patients undergoing parathyroidectomy." First thing I did in the morning was insist on seeing the surgeon in person. I wanted zero chance for error. Fortunately, the surgeon was familiar with her case and knew this was an error. Suppose, however, the surgeon was not so knowledgeable about the patient, or unavailable, or called away for some emergency and someone else filling in? I do not know if the error was simple human error by the NP or someone prior who'd performed data entry, a wrong selection due to a mission hostile user interface in the setting of overwork, a computer error due to some cross-link between (to non biomedical personnel) two similar-sounding terms - parathyroid vs. thyroid - or some other cause. Needless to say, if this error had resulted in an unnecessary and injurious parathyroidectomy and necessity for followup thyroidectomy on a postoperative area, and had been as a result of IT problems either totally or partially , it is likely the vendor would have been "held harmless" and the defect nondisclosed to other organizations. (Anecdotally, on going to the bathroom, I also noted a group of residents on rounds energetically discussing what "template" was the correct one in which to enter patient data of some type. When I rounded years ago, I remember discussing medical issues...) While I agree the likelihood of major IT contribution to this error was low, this was a reminder of just how problematic healthcare quality can be, even with advanced IT. I think the solution is not to see IT as a panacea, and maintain adequate human involvement (with humans not overburdened feeding the bureaucratic machine) in safety issues. -- SS

Cannot Get Away From Medical Information Errors, Continued

In " This informaticist can't escape clinical IT issues even on personal business ", I observed that I encountered HIT informa...

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On Optimal Expertise for Leadership in Biomedicine

There has recently been debate on these pages regarding optimal expertise for biomedical leadership, precipitated by Roy Poses' posts "<a href="http://hcrenewal.blogspot.com/2009/08/health-care-leaders-dont-know-much.html">Health Care Leaders: Don't Know Much About Health Care</a>" and "<a href="http://hcrenewal.blogspot.com/2009/08/ny-times-proclaims-anyone-can-run.html">NY Times Proclaims Anyone Can Run a Health Care Organization with a Little Studying Up</a>". I am resurfacing a post I wrote in Jan. 2009 entitled "<a href="http://hcrenewal.blogspot.com/2009/01/pfizerwyeth-merger-and-sacrificing.html" rel="nofollow">Pfizer/Wyeth Merger And Sacrificing The Future: Laying Off Scientific Staff All Over The Place</a>" that I believe succinctly states the problems with 'management by amateur.' Read the entire post, but here are the highlights: <blockquote>... Those in charge [and who lack domain credentials -ed.] cannot see that which the domain specialist sees. They cannot see because they lack the training, experience, and what is described as 'meta-competence' (in <a href="http://gagne.homedns.org/%7Etgagne/contrib/unskilled.html">this brilliant article</a> on competence [the Dunning-Kruger effect - ed.]) essential to seeing that which is obvious. Obvious, that is, to those who do not lack these characteristics. In addition, I've also observed that some lack the fundamental analytical abilities essential to understanding and managing the complexities of biomedical R&D. Why those without domain expertise are in charge of organizations whose long term viability depends entirely on the most advanced and creative pursuit of biomedical 'miracles' is another matter. I won't address this here, other than saying it reflects the adverse consequences of a bias that has evolved in management "science." That bias is the belief that all the world consists of faceless labor resources performing easily definable processes upon interchangeable widgets, and that management can therefore be done by generic managers, exclusively. Some of the world is like that [i.e., fast food chains - ed.], but some isn't, such as biomedical R&D. [And clinical medicine as well - ed.] <div style="text-align: left;">Management in the absence of domain expertise in this industry is, in fact, mismanagement. </div> There is nothing here to spin, there is nothing to debate. There is nothing to discuss. This is a first principle. Failure to accept this reality results in corporate failure. </blockquote>Those who believe otherwise are engaging in magical thinking. Further, those without biomedical domain knowledge who disagree should be prepared to discuss how their lack of domain knowledge might affect their insights and opinions on such complex matters, compared to those with both domain knowledge and leadership experience. A question is this: based on the same Western traditions of inquiry and <a href="http://freeinquiry.com/critical-thinking.html">critical thinking</a> that led to modern biomedical science and its accomplishments, whose opinion is likely to be more valid? -- SS

On Optimal Expertise for Leadership in Biomedicine

There has recently been debate on these pages regarding optimal expertise for biomedical leadership, precipitated by Roy Poses' posts ...

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Translate documents: sharing across languages and generations

My cousin is in first grade and sometimes she writes short stories for class. I try to share the stories with her grandparents, but because Japanese is their first language and they don't speak English very well, it's been tough. Today we're releasing a feature for <a href="http://docs.google.com/">Google Docs</a> to make this kind of multi-lingual sharing easier — you can now automatically translate documents into <a href="http://www.google.com/intl/en/help/faq_translation.html#langpairs">42 different languages</a>. So for my cousin's latest story, I helped her type it up in Google Docs and then clicked "Translate document" from the "Tools" menu. In a matter of seconds, Google Docs has translated the whole story into Japanese using <a href="http://www.google.com/intl/en/help/faq_translation.html#whatis">Google Translate's technology</a>. <a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhg4rtLsTAkQtZHNjN83EKUeFsJQXH6YZbW0r2jFYaTPaZlf5gDxv4e7_hrDAnrgmX2oN2ECT4niIme0MvTJptV51JOihofOs91vcM8Bljy5NwlTluyjcsHTYUqxam6pPLR5vUDJRynd0Af/s1600-h/docs1.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5374671815542712786" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhg4rtLsTAkQtZHNjN83EKUeFsJQXH6YZbW0r2jFYaTPaZlf5gDxv4e7_hrDAnrgmX2oN2ECT4niIme0MvTJptV51JOihofOs91vcM8Bljy5NwlTluyjcsHTYUqxam6pPLR5vUDJRynd0Af/s400/docs1.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 267px;" /></a> <a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPoFdWhrACGTQwW6rE-Y6VTH-ScNvG6Gd8sWFRb-wdsoSOt-XcLN0QD0e53HBYJ0wSfktfwrFYsXlvPfvUeU0_88v5vi01-VSNHyyCEi8WrV2z5wGF77LmMSrPW4n9vkApKyMGciDoF_Ai/s1600-h/docs2.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5374672032057769922" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPoFdWhrACGTQwW6rE-Y6VTH-ScNvG6Gd8sWFRb-wdsoSOt-XcLN0QD0e53HBYJ0wSfktfwrFYsXlvPfvUeU0_88v5vi01-VSNHyyCEi8WrV2z5wGF77LmMSrPW4n9vkApKyMGciDoF_Ai/s400/docs2.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 270px;" /></a> You can replace the original document with the translation or make a new translated version. I like keeping an English version for friends here and creating a separate Japanese version for her grandparents. All the formatting and layout is preserved no matter what language it's in — translations aren't perfect, but we are continuously working on improving translation quality over time. We hope this new feature helps you more easily share information without worrying about language barriers. Posted by Rita Chen, Associate Product Manager Intern, Google Docs

Translate documents: sharing across languages and generations

My cousin is in first grade and sometimes she writes short stories for class. I try to share the stories with her grandparents, but because ...

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Cross-occupational invasion of medicine by IT, exemplified

I have written on these pages about a cross-occupational invasion of medicine by IT personnel, wherein the IT personnel seem to forget that they are facilitators of healthcare, not enablers, with a primary purpose of serving the needs of clinicians.<div> </div><div>The <a href="http://www.histalk.com/">HISTalk</a> site recently posted an attorney's views on the "hold harmless" and "defects nondisclosure" controversy <a href="http://jama.ama-assn.org/cgi/content/extract/301/12/1276">first reported on by Koppel and Kreda</a> in JAMA, and amplified in my <a href="http://hcrenewal.blogspot.com/2009/07/health-care-information-technology.html">letter to the editor</a> in the same publication. The attorney's views at HISTalk (link below) are quite reasonable regarding such practices.</div><div> </div><div>However, the user comments thread reveals some attitudes exemplifying the "invasion" of which I've written. Both the attorney's post and the responses by a poster under the nom-de-blog "Programmer" to others' concerns can be read <a href="http://histalk2.com/2009/08/24/hitlaw-82409/">at this link</a>.</div><div> </div><div>Read it all. The attitudes of "Programmer" (assuming they are genuine, which is likely) are remarkable.</div><div> </div><div>-- SS </div>

Cross-occupational invasion of medicine by IT, exemplified

I have written on these pages about a cross-occupational invasion of medicine by IT personnel, wherein the IT personnel seem to forget that ...

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Five years of introducing students to open source

<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiNBefv5FOOWCcB3oCsVMdrya1YtaF2TyRmOEIwgWaC6dvDYoz-ltMKqiLiyZaJKCs88EO8EBqGTPSUFYbycNNLnNDlsuYdkNpEKLTr5UHXq6nm2rAVELvXQwXgYSvfkEPcNBMhNdRMtpm/s1600-h/GSOCLogo2009.png"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5374350768142386402" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiNBefv5FOOWCcB3oCsVMdrya1YtaF2TyRmOEIwgWaC6dvDYoz-ltMKqiLiyZaJKCs88EO8EBqGTPSUFYbycNNLnNDlsuYdkNpEKLTr5UHXq6nm2rAVELvXQwXgYSvfkEPcNBMhNdRMtpm/s320/GSOCLogo2009.png" style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 320px; height: 214px;" /></a>We've just concluded our fifth <a href="http://code.google.com/soc/">Google Summer of Code</a>, our <a href="http://googleblog.blogspot.com/2009/03/supporting-students-in-open-source.html">flagship global program</a> to introduce college and university students to open source development. Once again, the results this year have been impressive. Nearly 2,000 mentors from 64 countries participated in the program. They worked to bring 1,000 students from 69 countries into the communities of <a href="http://socghop.appspot.com/program/accepted_orgs/google/gsoc2009">150 free and open source projects</a>. We're particularly excited this year to have introduced several students to open source development that has a direct impact on social causes, from <a href="http://socghop.appspot.com/org/home/google/gsoc2009/mifos">microfinance software</a> to <a href="http://socghop.appspot.com/org/home/google/gsoc2009/sugarlabs">global educational initiatives</a> to <a href="http://socghop.appspot.com/org/home/google/gsoc2009/sunlight">making government data more transparent and accessible</a>. Three months and hundreds of thousands of lines of code later, 85 percent of our student participants have successfully completed their projects. We'll be publishing more extensive program statistics and wrap up reports in the coming weeks on the <a href="http://google-opensource.blogspot.com/">Google Open Source Blog</a>, so stay tuned there for more news about Google Summer of Code. We'd like to congratulate all of our student participants for their hard work and tremendous achievements this summer. We're excited to hear that many of our students have planned out the next few months of their coding work with their chosen open source project. Finally, our sincerest thanks to all of our mentors for volunteering their time and expertise to help these students more actively engage with open source development. <a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL033tQbAwIUwnaaqHP1SPoq07cHjn9TPUJqrk4O_fUsfFqK-yd1K_Xjijvq1KMIgwsfcX3czt5WXnuii4VzWjaF6TlxC5Lm7G0HVE5vPutWlj5qXNGILu-Wgn9RWKEUkZyb8TQXp1TRtz/s1600-h/soc.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5374350985593503762" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL033tQbAwIUwnaaqHP1SPoq07cHjn9TPUJqrk4O_fUsfFqK-yd1K_Xjijvq1KMIgwsfcX3czt5WXnuii4VzWjaF6TlxC5Lm7G0HVE5vPutWlj5qXNGILu-Wgn9RWKEUkZyb8TQXp1TRtz/s400/soc.jpg" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 400px; height: 300px;" /></a> Posted by Leslie Hawthorn, Program Manager, Open Source Team

Five years of introducing students to open source

We've just concluded our fifth Google Summer of Code , our flagship global program to introduce college and university students to open...

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More books in more places: public domain EPUB downloads on Google Books

Try doing a search for [<a href="http://books.google.com/books?q=hamlet&btnG=Search+Books">Hamlet</a>] on Google Books. The first few results you'll get are "Full View" books — which means you can read the full text. And, because the book is in the public domain, you can also download a copy of <a href="http://books.google.com/books?id=VBoVAAAAYAAJ&printsec=frontcover&dq=hamlet&ei=bFOVSpTIAojMlQSP95WcBw#v=onepage&q=&f=false">Hamlet</a> in PDF form. Starting today, you'll be able to download these and over one million public domain books from <a href="http://books.google.com/">Google Books</a> in an additional format. We're excited to now offer downloads in EPUB format, a free and open industry standard for electronic books. It's supported by a wide variety of applications, so once you download a book, you'll be able to read it on any device or through any reading application that supports the format. That means that people will be able to access public domain works that we've digitized from libraries around the world in more ways, including some that haven't even been built or imagined yet. We founded Google Books on the premise that anyone, anywhere, anytime should have the tools to explore the great works of history and culture. We began digitizing these books because we thought it was important for people to be able to find and read them, and we want them to be able to do so anywhere — not just when they happen to be at a computer. This feature takes us one step closer towards realizing that goal by helping support open standards that enable people to access these books in more places, on more devices and through more applications. To find out more, check out our post on the <a href="http://booksearch.blogspot.com/2009/08/download-over-million-public-domain.html">Google Books blog</a>. Posted by Brandon Badger, Product Manager

More books in more places: public domain EPUB downloads on Google Books

Try doing a search for [ Hamlet ] on Google Books. The first few results you'll get are "Full View" books — which means you ca...

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Health Care Leaders: Don't Know Much About Health Care

Our recent <a href="http://hcrenewal.blogspot.com/2009/08/ny-times-proclaims-anyone-can-run.html">post</a> about health care organizations recruiting executives with no experience in or knowledge about giving health care or biomedical science has attracted some attention. Some people suggested that letting some people from the "outside" into health care leadership might lead to fresh thinking and new ideas. My concern was not about that. However, I do believe that to be succesful, the leadership of health care organizations ought to collectively be knowledgeable about health care, and understand its context, culture, science base, and values. My concern was not about a few "fresh thinkers," but that the preponderance of health care leaders today know little about what it's like to actually take care of patients, have little understanding of biomedical science and health care research, and do not understand, much less share the values of clinicians. To illustrate with some admittedly anecdotal data, I looked up the official biographies of the CEOs of some health care organizations that have recently been mentioned in Health Care Renewal. I selected the most recently mentioned examples of the following types of health care organizations: hospitals and health care systems, managed care organizations/ health care insurers, pharmaceutical companies, device companies, biotechnology companies, and health care information technology companies. Here are the results. Hospitals/ Health Care Systems Example: Sutter Health CEO: Patrick Fry <a href="http://www.sutterhealth.org/about/ourteam/">Biography</a>: <blockquote> Mr. Fry joined the Sutter organization in 1982 as an administrative resident at Sutter General Hospital in Sacramento. Over the ensuing years he held increasingly responsible administrative positions both at the local affiliate level and region level, with responsibilities covering the breadth of Sutter Health's services. After serving as regional president for Sutter Health’s affiliates in the greater Sacramento region, Mr. Fry became president of the organization’s eastern operations. He later assumed leadership of Sutter Health’s Western Division and in 2000 became Sutter Health’s second-in-command, serving as chief operating officer and executive vice president. In 2005 Mr. Fry became President and CEO. Mr. Fry earned a bachelor’s degree in public health administration from the University of California, Davis in 1979 and earned a master’s degree in health services administration from George Washington University in Washington, D.C. </blockquote> Managed Care Organizations/ Health Care Insurers Example: WellCare CEO: Heath Schiesser <a href="http://www.wellcare.com/aboutus/managementteam">Biography</a>: <blockquote> Heath Schiesser assumed the role of president and chief executive officer in January 2008. He originally joined WellCare in 2002 as senior vice president of Marketing and Sales and focused most of his effort on the growth of the Company’s Medicaid and Medicare businesses. As president of WellCare Prescription Insurance, he led the Company's successful national entry into Medicare prescription drug plans. Between mid-2006 and the assumption of his current position in January, he served in a part-time role as a senior advisor, focusing on WellCare’s rapidly growing Medicare products. Mr. Schiesser brings extensive experience in improving operations, developing strategies and growing businesses in several sectors. Prior to joining the Company, he worked at the management consulting firm of McKinsey & Company, co-founded an online pharmacy for pharmacy benefit manager Express Scripts and worked in the development of new ventures. A cum laude graduate of Trinity University, Mr. Schiesser received his Master of Business Administration from Harvard University. </blockquote> Pharmaceutical Companies Example: Johnson and Johnson CEO: William C. Weldon <a href="http://www.investor.jnj.com/governance/managementdetail.cfm?bioid=19175">Biography</a>: <blockquote> William C. Weldon is Chairman of the Board and Chief Executive Officer of Johnson & Johnson, the world's most comprehensive and broadly based health care products company. Mr. Weldon assumed his current responsibilities in April, 2002. Previously Mr. Weldon served as Worldwide Chairman, Pharmaceuticals Group, and a Vice Chairman of the Board of Directors. He was elected to the Board in February, 2001. Mr. Weldon joined Johnson & Johnson in 1971 in the sales and marketing department of its McNeil Pharmaceutical subsidiary. In 1982 he was named manager, ICOM Regional Development Center in Southeast Asia. Mr. Weldon was appointed executive vice president and managing director of Korea McNeil, Ltd., in 1984 and managing director of Ortho-Cilag Pharmaceutical, Ltd., in the U.K. in 1986. In 1989, he was named vice president of sales and marketing at Janssen Pharmaceutica in the U.S., and in 1992 he was appointed president of Ethicon Endo-Surgery. In 1995 Mr. Weldon was named a company group chairman of Johnson & Johnson and Worldwide Franchise Chairman of Ethicon Endo-Surgery, the Johnson & Johnson affiliate that develops new procedures for minimally-invasive surgery and designs related products. In 1998 Mr. Weldon was promoted to the Executive Committee and named Worldwide Chairman, Pharmaceuticals Group. Among his outside activities, Mr. Weldon is a member of the Board of Directors of JPMorgan Chase & Co. He is also Chairman of the CEO Roundtable on Cancer, Vice Chair of The Business Council and a member of The Sullivan Commission on Diversity in the Health Professions Workforce. Mr. Weldon also serves on the Liberty Science Center Chairman's Advisory Council and as a member of the Board of Trustees for Quinnipiac University. He previously served as Chairman of the Pharmaceutical Research and Manufacturers of America (PhRMA). Mr. Weldon was born in Brooklyn, NY, and is a graduate of Quinnipiac University in Hamden, Connecticut. He and his wife have two children and one grandson. </blockquote> Device Companies Example: Medtronic CEO: William A. Hawkins <a href="http://wwwp.medtronic.com/Newsroom/Biography.do?itemId=1100621535750&lang=en_US">Biography</a>: <blockquote> Bill Hawkins assumed the role of Chief Executive Officer of Medtronic, Inc. in August 2007 and became Chairman of the Board in August 2008. He was named President and Chief Operating Officer in May 2004 after joining Medtronic as Senior Vice President and President of Medtronic's Vascular business in January 2002. Bill joined Medtronic from Novoste Corp., where he had been President and Chief Executive Officer since 1998. Previous positions included Corporate Vice President and President of the Sherwood Davis and Geck organization of American Home Products; President of the Ethicon Endo-Surgery organization of Johnson & Johnson; President, Devices for Vascular Intervention and U.S. Operations, for Guidant Corp.; and several increasingly responsible executive positions culminating in the presidency of the Ivac organization for Eli Lilly & Co. He began his medical technology career with Carolina Medical Electronics in 1977. He received his bachelor’s of science degree in electrical and biomedical engineering from Duke University in 1976 where he also conducted medical research in pathology. Bill also earned a master’s degree in business administration from the Darden School of Business, University of Virginia, in 1982. Bill is a member of the Board of Visitors of the Engineering School of Duke University and the Guthrie Theatre Board. </blockquote> Biotechnology Companies Example: Dendreon CEO: Mitchell H Gold, MD <a href="http://www.dendreon.com/about/leadership_team/mitchell_h_gold_md/default.asp">Biography</a>: <blockquote> Dr. Gold joined Dendreon in 2001 as the vice president of business development. He subsequently was appointed a director in 2002 and was named the chief executive officer of the Company in 2003. Dr. Gold has led the Company’s corporate development, acquisition and financing efforts in recent years, completing transactions valued at approximately $225 million, including the acquisition of Corvas International, and raising approximately $350 million in capital. Prior to joining Dendreon, he served as the vice president of business development for Data Critical Corporation, a company engaged in wireless transmission of critical healthcare data, now a division of GE Medical. He also served as the co-founder, president and chief executive officer of Elixis Corporation, a medical information systems company. Dr. Gold is a former urologist at the University of Washington and currently serves on the boards of the University of Washington/Fred Hutchinson Cancer Research Center Prostate Cancer Institute and the Washington Biotechnology and Biomedical Association. Dr. Gold received his B.S. from the University of Wisconsin-Madison and his M.D. from Rush Medical College in Chicago. </blockquote> Health Care Information Technology Companies Example: Allscripts CEO: Glen Tullman <a href="http://www.allscripts.com/company/glen-tullman.asp">Biography</a>: <blockquote> Glen E. Tullman joined Allscripts as Chief Executive Officer in August 1997 to lead the Company's transition into the Healthcare Information Sector. He led the Company's Initial Public Offering and Secondary Offerings of the Company, which is now traded on NASDAQ (MDRX) and has driven the Company to becoming the leading provider of clinical software, connectivity and information services to physicians. Prior to joining Allscripts, Mr. Tullman was Chief Executive Officer of Enterprise Systems, Inc., a leading healthcare information services company providing resource management solutions to large integrated healthcare networks, from October 1994 to July 1997. Mr. Tullman led the company's Initial Public Offering and secondary offerings. HBO and Company of Atlanta acquired Enterprise in 1997 in a stock transaction valued in excess of $250 million. From 1983 to 1994, Mr. Tullman served in a number of management roles including President and Chief Operating Officer of CCC Information Services, Inc., a provider of information systems to the country's largest property and casualty insurers. Under his leadership, the company grew from $17 million to more than $100 million and is publicly traded. Mr. Tullman graduated from Bucknell University Magna Cum Laude, with a double major in Economics and Psychology. Upon graduation, he joined the Executive Office of the President of the United States in Washington, D.C. and later accepted a fellowship to study social anthropology at St. Antony's College, Oxford University, England. Mr. Tullman serves on the International Board of the Juvenile Diabetes Research Foundation and on the Board of Trustees of the Certification Commission for Healthcare Information Technology (CCHIT). He also is Co-Chair of the National ePrescribing Patient Safety Initiative (NEPSI), a $100 million campaign, led by Allscripts and Dell Computers, to deliver free electronic prescribing to every physician in America. In 2006, he was named CEO of the Year by the Illinois Information Technology Association. </blockquote> So there we have the leaders of seven important health care oganizations. Only one is health care professional (although he is described as a "former urologist.") Only one of them claims any biomedical science experience, and that was in college. One has bachelors and masters level degrees in health administration, and another has a bachelors degree in electrical and biomedical engineering. That seems to be the sum total of the group's experience, expertise, and formal training in health care and biomedical science. Only one claims any experience directly taking care of patients. Only one has training in any health care profession. Only one is a (?"former"?)doctor, nurse, therapist, or biomedical scientist. Of course, there are at least thousands of health care organizations in the US alone, each with its own often large (and some might say top-heavy) management teams. But I would wager that if there was a systematic survey of these leaders, the majority would turn out not to be health care professionals, not to be biomedical scientists, and not to have much direct health care experience. I would further wager the larger the organization, the less health care experience, knowledge and training would be found among the leadership. I repeat, 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.

Health Care Leaders: Don't Know Much About Health Care

Our recent post about health care organizations recruiting executives with no experience in or knowledge about giving health care or biomed...

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