Where to begin?

Maryland Association for Healthcare Quality

I flew to Annapolis on Wednesday to speak at one of the semi-annual educational conferences of the Maryland Association for Healthcare Quality. I’ve known the MAHQ president, Monica, for several years; in fact, she keynoted the Michigan Association for Healthcare Quality conference I hosted in Traverse City two years ago. Lovely lady.

The MAHQ event lasted one full day. My colleague Gayle ran the morning session — about advanced Excel tips and an introduction to some intermediate-level statistical concepts — and I led the three-hour afternoon block. My session focused on the “why” of health data analytics; I presented a list of characteristics of a high-performing team, then I presented real-life use cases illuminating the value of each characteristic.

I also presented what’s increasingly my personal call-to-action about health data analytics:

Health care is in a value crisis precipitated by suboptimal structures and misaligned incentives. We’ve mostly eaten the low-hanging fruit from IOM/IHI. The sole remaining path for driving improvements in cost/outcomes/access/satisfaction rests in data-driven PI initiatives. Yet, our industry’s capability is still in its infancy. Until we get smart about data, costs will go up — and we’ll continue to inflict avoidable harm or even death on the patients we serve.

On a personal note, it was lovely to have dinner with Gayle and Stephanie at the Severn Inn on Wednesday. Our table overlooked the Severn River, immediately across the water from the United States Naval Academy. The cover photo for this post, in fact, was taken from the Inn’s parking lot. And on Thursday, Monica took me to the Fleet Reserve Club, where she’s a member, to enjoy drinks and to see the sights along the Ego Alley (Spa River) waterfront. A lovely experience.

This trip also marked my first time flying United Airlines. Good experience. The planes were in clean condition. The flight attendant on the ORD-to-BWI leg was wonderful. However, the biggest lesson is that despite how often I shuffle through O’Hare — a dank, crowded place that reminds me of Dallas-Fort Worth — United operates Concourse C at Terminal 1, which is beautiful, tall, light and airy. American Airlines hangs around Terminal 3, which is a much more depressing place.

Bat in the Bedroom

The morning after Memorial Day, I was awoken by the sound of my feline overlords chasing a bat in my bedroom. I caught the bat safely. I then deduced that neither I nor the kitties had been bitten or scratched by the little winged devil. So I carefully released the bat back into the wild.

Good idea, right?

Well, later that week, a co-worker came across a story on NPR about bats in the bedroom. And thus began a Seinfeldian journey of ridiculousness. For starters, the U.S. Centers for Disease Control and Prevention recommends that people seek post-exposure treatment for rabies if they awake to a bat in their bedroom, even if they’re confident they weren’t bitten. Accordingly, I use the MyHealth app to leave a “non-emergency medical question” with my physician. His medical assistant calls me and basically says: “We don’t know nuthin’ ‘but no bats; you better call the health department.” So I did. And the public-health nurse on the other end of the line — besides having a delightfully morbid sense of humor — suggested that there wasn’t any real risk and that Canada has abandoned the CDC’s strict rules because the CDC’s recommendations followed from a decade-long observation period with a total N count of five infected humans. Then she said the only two bats in Kent County that tested positive for rabies so far this year are both from my street, so maybe I should consider it anyway. Which … well, my street is very long. So then there’s the “do I go to the E.R. for shots, or not?” question, which boils down to this: Do you spend a ton of money to go to the ER for injections, knowing that you have an infinitesimally small risk of acquiring a virus that’s effectively 100 percent fatal, or not?

It’s the Precautionary Principle run amok, and an excellent case study in why we have so much waste in the health care industry.

And then, of course, the “what about the kitties?” question.

I figure I’ll take the cats to the vet this coming week, but I’m not going to get poked, myself. So if you see me frothing at the mouth later this summer — you’ll know I chose poorly. And that you should stay out of biting range.

Miscellaneous Morsels of Misanthropy

• Although I’ll keep the victims (and their loved ones) of the Orlando shooting in my thoughts and prayers, I’m disappointed — but not surprised — that the immediate reaction circled around gun control. In Kalamazoo earlier this week, a crazy man plowed into a group of cyclists with his truck, killing five, but no one’s calling for a ban on automobiles. As long as we’re polarized about firearms, we’re going to continue to miss the point about the triggers of social decay that make mass-violence episodes occur in the first place. And more will die as a result. This is, foremost, a cultural problem, which requires solutions that transcend legislation.
• Our writer’s meeting went well on Friday. We’re going to Ann Arbor next weekend to sell books at the Ann Arbor Book Festival. I’m excited.
• I nearly forgot to mention — a few weeks ago, my friend Jared stopped into town for a visit. He used to live/work here, but he and his wife took up employment in Abu Dhabi. It was nice to connect. I’m going to interview him, and a few others, for the next issue of The 3288 Review. And I’m probably going to take him up on his offer to visit him in the Middle East.
• Speaking of The 3288 Review — it’s on sale. Buy now, before we sell out! Copies arrived this past Wednesday. It’s a lovely volume. As usual, my column appears in the back; this time, I wrote about the literary representation of rape.

Where to begin?
Maryland Association for Healthcare Quality
I flew to Annapolis on Wednesday to speak at one of the semi-annual educational conferences of the Maryland Association for Healthcare Quality. I’ve known the MAHQ president, Monica, for several years; in fact, she keynoted the Michigan Association for Healthcare Quality conference I hosted in Traverse City two years ago. Lovely lady.
The MAHQ event lasted one full day. My colleague Gayle ran the morning session — about advanced Excel tips and an introduction to some intermediate-level statistical concepts — and I led the three-hour afternoon block. My session focused on the “why” of health data analytics; I presented a list of characteristics of a high-performing team, then I presented real-life use cases illuminating the value of each characteristic.
I also presented what’s increasingly my personal call-to-action about health data analytics:

Health care is in a value crisis precipitated by suboptimal structures and misaligned incentives. We’ve mostly eaten the low-hanging fruit from IOM/IHI. The sole remaining path for driving improvements in cost/outcomes/access/satisfaction rests in data-driven PI initiatives. Yet, our industry’s capability is still in its infancy. Until we get smart about data, costs will go up — and we’ll continue to inflict avoidable harm or even death on the patients we serve.

On a personal note, it was lovely to have dinner with Gayle and Stephanie at the Severn Inn on Wednesday. Our table overlooked the Severn River, immediately across the water from the United States Naval Academy. The cover photo for this post, in fact, was taken from the Inn’s parking lot. And on Thursday, Monica took me to the Fleet Reserve Club, where she’s a member, to enjoy drinks and to see the sights along the Ego Alley (Spa River) waterfront. A lovely experience.
This trip also marked my first time flying United Airlines. Good experience. The planes were in clean condition. The flight attendant on the ORD-to-BWI leg was wonderful. However, the biggest lesson is that despite how often I shuffle through O’Hare — a dank, crowded place that reminds me of Dallas-Fort Worth — United operates Concourse C at Terminal 1, which is beautiful, tall, light and airy. American Airlines hangs around Terminal 3, which is a much more depressing place.
Bat in the Bedroom
The morning after Memorial Day, I was awoken by the sound of my feline overlords chasing a bat in my bedroom. I caught the bat safely. I then deduced that neither I nor the kitties had been bitten or scratched by the little winged devil. So I carefully released the bat back into the wild.
Good idea, right?
Well, later that week, a co-worker came across a story on NPR about bats in the bedroom. And thus began a Seinfeldian journey of ridiculousness. For starters, the U.S. Centers for Disease Control and Prevention recommends that people seek post-exposure treatment for rabies if they awake to a bat in their bedroom, even if they’re confident they weren’t bitten. Accordingly, I use the MyHealth app to leave a “non-emergency medical question” with my physician. His medical assistant calls me and basically says: “We don’t know nuthin’ ‘but no bats; you better call the health department.” So I did. And the public-health nurse on the other end of the line — besides having a delightfully morbid sense of humor — suggested that there wasn’t any real risk and that Canada has abandoned the CDC’s strict rules because the CDC’s recommendations followed from a decade-long observation period with a total N count of five infected humans. Then she said the only two bats in Kent County that tested positive for rabies so far this year are both from my street, so maybe I should consider it anyway. Which … well, my street is very long. So then there’s the “do I go to the E.R. for shots, or not?” question, which boils down to this: Do you spend a ton of money to go to the ER for injections, knowing that you have an infinitesimally small risk of acquiring a virus that’s effectively 100 percent fatal, or not?
It’s the Precautionary Principle run amok, and an excellent case study in why we have so much waste in the health care industry.
And then, of course, the “what about the kitties?” question.
I figure I’ll take the cats to the vet this coming week, but I’m not going to get poked, myself. So if you see me frothing at the mouth later this summer — you’ll know I chose poorly. And that you should stay out of biting range.
Miscellaneous Morsels of Misanthropy

• Although I’ll keep the victims (and their loved ones) of the Orlando shooting in my thoughts and prayers, I’m disappointed — but not surprised — that the immediate reaction circled around gun control. In Kalamazoo earlier this week, a crazy man plowed into a group of cyclists with his truck, killing five, but no one’s calling for a ban on automobiles. As long as we’re polarized about firearms, we’re going to continue to miss the point about the triggers of social decay that make mass-violence episodes occur in the first place. And more will die as a result. This is, foremost, a cultural problem, which requires solutions that transcend legislation.
• Our writer’s meeting went well on Friday. We’re going to Ann Arbor next weekend to sell books at the Ann Arbor Book Festival. I’m excited.
• I nearly forgot to mention — a few weeks ago, my friend Jared stopped into town for a visit. He used to live/work here, but he and his wife took up employment in Abu Dhabi. It was nice to connect. I’m going to interview him, and a few others, for the next issue of The 3288 Review. And I’m probably going to take him up on his offer to visit him in the Middle East.
• Speaking of The 3288 Review — it’s on sale. Buy now, before we sell out! Copies arrived this past Wednesday. It’s a lovely volume. As usual, my column appears in the back; this time, I wrote about the literary representation of rape.