Policy-Compliant Healthcare Fail
Just like any roadway, the healthcare system needs signals that work. Too many signals and the system arrests. Too little and everything crashes. It’s important to build a system of healthcare that anyone can use safely. It doesn’t need to be complicated. It just needs to work. So why might our system have so many jams and fails?
After seeing this video that Seth Godin shared on his blog, I started thinking about what might be wrong with how we provide healthcare. So many rules have to be followed that I think we end up breaking them right onto each other. When you watch this video, consider how our healthcare system builds policy-compliant accidents:
If you have ever worked in a corporate environmnet, you completely get this video. Painfully, it’s dead-on with the fundamental problems of complex organizational behaviors. Governmental organizations often operate with as much derrangement.
So my question about Healthcare Fail is this: if corporations and governments operate healthcare the same way as the geniuses designing the stop sign in the video do, just who or what is the right choice? It’s easy to say “the free market works”, as the political Right claim, or “healthcare should be free for everyone”, as the Left claim. Honestly, I don’t think either of those claims make any sense these days. I wish one of those claims were true. It would make our problem easier to solve. Simple-mindedness is not simplicity.
As the costs of healthcare increase inversely with the quality provided, our public discussion focuses more on Universal Healthcare initiatives. Unfortunately, I think that our emphasis on cost has largely gotten us into trouble. It’s as if Werner Heisenberg’s uncertainty principle is meliciously at work: the more we try to batten costs down, the higher they fly.
Rather than focusing on cost, we aught to focus on the value provided to patients and the community. Once the public understands what really goes into providing quality healthcare, then we might have a chance at a benefiting from a system that is neither the result of Capitalist Fail or Socialist Fail.
Our health is too important to hand over to corporations or governments. We need another kind of organization altogether, a totally novel way to provide quality care. I wish I had a name for it. For now let’s call it the Godinizaiton of Healthcare.
Godinize the Healthcare System
Part of the problem with the economics of healthcare is that we try to satisfy every conceivable end-point. It’s important that healthcare involves regulatory controls and well-conceived designs. If every intersection involves convoluted stop signs built to comply with everybody’s rules, we will have nothing but very reliable policy-compliant Healthcare Fail.
Policy-compliance is not a goal of healthcare: healthcare is the goal of healthcare.
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Work-Life Balance Is a Hoax
Image via WikipediaYou are probably one of millions of Americans in search of balance between work and life. I too have searched for that elusive condition in the past. But it’s a hoax my friends. It’s a trick the mind plays when we’re trying to escape from the inevitable stresses of life. Trying to find balance in your life is like trying to balance a bag of water on your head while hopping on one leg. It’s theoretically possible but you’ll look like a damn fool.
Sometimes when the stresses of life wear on us we seek an escape. Doing work that you don’t have any passion for is one definition of hell. Here’s my theory about getting out of hell: the way out of hell is through. That’s not the path that most of us take. Why not? My answer: because that way is laden with fear and danger. We avert both because we attach to familiarity and comfort.
A mind that neither averts nor attaches is the only one beyond the surface-tension we call suffering. That kind of mind doesn’t look for balance because it knows there’s nothing but imbalance. That kind of mind delights in the chaos embedded into every facet of our world. Look into the night-sky. Do you see balance? Or do you see a beauty in the imperfect swirling of it all? Could you look upon your life that same way? If you could, what would you see?
If you continue to go to a cog job because you have to pay your bills, then do what you have to do. But before you beat yourself up with constant ruminations of how you need to find balance between work and home-life, why not try to do some soul-digging first? Why not find out what’s really bugging you? These are important actions to take, because if you leave one way of life for another, you still have the same brain to suffer from the stresses of life. There is no way out your mind. If you find a way out, email me: info /*at*/ philbaumann.com. Better yet: twitter me.
I’m telling you this because I encounter so many people who are fed up with their jobs and stressed between their paycheck-generators and their family life. I see a lot of depression, anxiety, mania and all sorts of painful conditions in the eyes of friends, relatives, and strangers. It’s a stressful world we’re creating, no doubt about that. I wish I could change things, but I can’t. Our world has always been stressful. It always will be.
So what’s the answer to the problem of being overly stressed between work and life? I could give you a list written for Digg. Instead I’ll just say that the answer is already within you. You know what it is. It’s your secret. You hid it away a long time ago. Our culture aided and abetted that little deception. You were told to be successful and you followed the advice. The lie was planted right from the start. You were already successful. You were already happy. You were OK.
The ancients called the balance you now seek The Pearl. That’s what they meant when they talked about the world as your oyster. What starts as a gritty irritation grows into a fascination. Throw away the grit and you’ll never find the pearl.
If you want me to help you out with a hint, all I can tell you is to follow your bliss. It’s a hard path to follow. It is a path of sacrifice, risk, danger. I ask you to consider: would life be worth anything without these three keys to truth?
We have within in us dark sparks burning to get out. Why put out the fire within you when you can set the word ablaze with your light? Bend into the work you do. The oyster does. Why can’t you?
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Are You Serious?
Image via WikipediaThe healthcare industry is full of serious people. They should be serious, shouldn’t they? After all, health care is serious business. Life is at stake and life is sacred. But if you had to choose between two different kinds of providers, which one would you prefer: the serious one or the responsible one? The two kinds aren’t necessarily the same. Being serious is an emotion. Responsibility is a state of awareness. That difference could seriously influence the quality of your treatment.
THE COST OF BEING SERIOUS
Most of the people in health care are good, competent and emotionally secure human beings. Unfortunately, there are also a lot of angry people in the same industry. I know that I don’t want an angry surgeon or ticked off nurse giving me a medication. Do you? Could anger stem from being serious? I believe that it could.
Our culture teaches us to be serious. There’s nothing wrong with being serious per se. But it’s worth a peek at what grows beneath the word. The root word of serious is seryows, which sounds a bit like sorrows. Ours is a serious world. It’s also sorrowful. Perhaps there’s a connection. If language influences our perceptions and behaviors, then we need to re-think what we teach our children. Otherwise, they will grow up to confuse seriousness with responsibility. They will be depressed. Look around you if you think I’m exaggerating.
THE BENEFITS OF BEING RESPONSIBLE
Fortunately, our culture teaches us to be responsible too. Resonsible is rooted in respuns, or response. Responsibility by definition requires action, a reply. Being responsible, however, is not the same as being serious and yet our culture often equates and confuses the two words. That’s an error that might be costing us lives.
I understand the need for bearing a sacred sense of emotion when providing care to patients. I’m not arguing against the sacred. I am arguing for stripping away the assumptions we make which prevent us from being our most responsible. Experienced professionals have smashed medical equipment against walls because they were serious about saving their patients’ lives. That’s pretty serious. It’s not responsible, especially when the equipment is life-saving.
Many health care facilities still tolerate this madness. Why? I think it’s because some of the people who run those organizations are serious about healthcare and they’re afraid that by condemning the serious behavior they are violating the sacredness of life. Health care is an ancient business. It’s an historical confluence of religion, warfare, science, art, culture and just about everything else that makes a civilization. So it’s not much of a wonder why the healthcare industry is so serious about being serious. The industry can do better. It’s your health, so it’s your responsibility too.
If you want to find out for yourself, offer to volunteer at your local hospital. See if there’s anything you can do to lighten things up.
LESS SERIOUS. MORE RESPONSIBILITY.
I think it’s time we publicly recognize the difference between being serious and being responsible. The two aren’t necessarily mutually exclusive; but the semantic relationship might just be too close for us to dismiss.
I know I want to be responsible. If that means I have to be less serious, so be it. Nursing might be a lot more fun. It should be. After all, life is a stake and life should be fun. Fun is a responsiblity of the living. Seriousness is for the dead. It’s our responsibility to save our sorrows for the dead. That’s how we rescue them.
If being serious leads to anger and anger leads to error, then we need to be less serious and more responsible. Life is at stake and life is sacred. Seriously.
If you have ideas on how to improve our health care responsibilities, please comment here. If you like what your reading, subscribe to my feed and we can continue the discussion.
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25 Words
It started
When I wrote my first lines.
I thought it was heaven
I was following.
Instead I found
a thread that led me home.
What was that all about? To find out what’s going on, go check out Liz Strauss’ remarkable blog.
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Twitter, HIPAA, Privacy and Freedom of Speech
Twitter will get you fired, fined or sued. Well, it will if you’re a health care professional who doesn’t follow the rules set down by the federal government and patient bills of rights. Here are some thoughts on how to Twitter safely in the clinical care setting.
WHAT HAPPENS ON TWITTER STAYS ON TWITTER…AND SUMMIZE AND…
Permission-based processes, whether you know it or not, have been a central dogma of medicine and nursing for many years. Acquiring informed consents or refusals has always been a right of patients, whether or not it was properly acknowledged by practitioners.
Twitter is a remarkable tool for broadcasting the latest advances in medicine or nursing. It’s also a way to establish an ambient intimacy within a community. Unfortunately, it has opened up a publicly viewable portal into the effluence of private patient information. What happens on Twitter, stays on Twitter…and Summize and FriendFeed and Disqus and ping.fm and Google’s cashes forever and ever and ever. Oh, and right on that PowerPoint slide which the plaintiff’s attorney ginormously projects onto a court room wide screen.
HIPPA IS DEFECTIVE LEGISLATION. BUT I FOLLOW ITS RULES.
Patients have a right to privacy when receiving care. That’s just common sense. Unfortunately, there have been legislative attempts to regulate how providers ensure patient privacy and information security. Those steps are honorable. Their execution, however, is matter for another blog post. Suffice it to say, HIPAA is not the optimal solution to the problem of patient information security.
HIPAA (Health Insurance Portability Accountability and Accountability Act of 1996) is one of those legislative examples of fighting the right war with the wrong means. Again, I won’t get into the merits of fighting HIPAA, but I’ll emphasize that until the act is properly amended, health care professionals are well advised to comply.
Why? Here are just two civil and crimianl penalties for non-compliance (Source):
- fines up to $25,000 for multiple violations of the same standard in a calendar year (ouch!)
- fines up to $250,000 and/or imprisonment up to 10 years for knowingly misusing individually identifiable health information (yikes!)
I’d hate to see any doctor or nurse lose their job, get fired or sued by a patient for violations that are easily avoided.
If you’re a health care provider and you plan on using Twitter or a similar tool to open up the world to what happens in the clinical setting (and I applaud you), here are two questions to ask yourself:
- Would I want my care to be broadcasted to who-knows-whom?
- Even if my name wasn’t mentioned, would I want my care to be on TwitterVision? If I do, did I sign a fully informed consent?
FREEDOM OF SPEECH
So, how could health care providers use Twitter to express their freedom of speech while protecting the information safety of patients? Here are some off-the-cuff suggestions:
- Be fictive with cases if your Twitter feed is on a public time-line
- Get permission, in writing, from patient’s or patient representatives
- Understand the ways in which protected health information privacy rights can be violated
- Remember that patient privacy is a part of patient safety
- Think about the purpose of a Tweet
- If you don’t have a real purpose to Tweet, don’t update
- Look at your license, recall that oath (I know corny, but it’s better than staring at a jail cell wall for 10 years)
I understand the excitement over using Twitter in a clinical setting (hey, I’m one of the advocates of Improvement through Health 2.0). But I don’t want that excitement to lose its luster in the wake of avoidable violations.
I’m not a big fan of HIPAA but I follow its rules. And so should you if you want to keep your license and practice the artful science of being a Jedi. Twitter’s awesome. But I’m not going to endanger my patient’s dignity and safety over it. All that, it ain’t.
Perhaps our first Tweets about the state of health care aught to be made about a wider discussion about how to simultaneously protect patient privacy and health professional sanity. HIPPA may be a stupidly constructed work of legislative ignorance, but it has the enforceable power to fine and jail you. Tweet Smart.
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