Titus Schleyer, DMD, PhD

on biomedical informatics and health information technology

Tag Archives: computing

Time to head to Washington, DC – for #AMIA2014!

Sandy packing up for #AMIA2014

Sandy packing up for #AMIA2014

It’s the time of year again where we gather up our booth items, such as brochures, giveaways (like our awesome t-shirt [free for qualifying participants]) and of course our “Belgian chocolate” coins, and head to the American Medical Informatics Association (AMIA) 2014 Annual Symposium in DC. (Thanks, Sandy, for getting it all together.) AMIA is the academic home of informatics, and the Symposium is the leading scientific meeting for biomedical and health informatics research and practice.

Many Regenstrief Institute CBMI faculty, staff and colleagues from other IU affiliates will attend the conference which runs from November 15-19, 2014, in Washington, DC. We are looking forward to reconnecting with colleagues, peers and old friends while catching some of their presentations.

Aside from the Schedule-at-a-glance, the best way to see what is happening and plan for the meeting is the Itinerary Planner. It is a great way to organize your attendance for keynote presentations, panels, papers sessions, the student design competition, and the many social events. Even better, the mobile app lets you access your itinerary on the move. We have also put together a (mostly) .

For this year’s Symposium, AMIA has created some new and exciting events, such as the “Scavenger Hunt” open to all attendees. This event is sure to bring more people to our exhibit booth #320 in search of the answers to the questions for the hunt. Other great events include Casino Night (a great way to meet people and try your luck at gambling at the same time), the four-mile Fun Run and the AMIA’s Got Talent! show. (I went there last year and had a blast –  here is a sampling of performances.)

Wear it proudly!

Wear it proudly!

We have two demonstrations, a couple of panels, four papers and seven posters from the Regenstrief/IU participants. Below you can find more information regarding these.

Starting the conference off are Titus Schleyer, Dan Vreeman, etc. with a didactic panel titled Squaring the Circle – Managing Local Healthcare Terminologies in the Age of Standardization on Sunday the 16th at 3:30 discussing current approaches to managing both standardized and local terminologies, elucidate challenges and opportunities, and future strategies to make the process more efficient and effective.

Be sure to catch Blaine Takesue, JT Finnell and Jon Duke Tuesday 11/18 (1:45) when they demonstrate Regenstrief’s homegrown teaching EMR (tEMR), designed to bridge the gap between what students are taught in medical school and what physicians need to know in real world practice.

We have several student presentations this year with the help of several CBMI faculty.

Regenstrief investigators Weiner, Zillich and Russ collaborated with others to design strategies to reduce prescribing errors Wednesday the 19th at 10:30).

We have seven poster presentations Monday and Tuesday:

Last, I am very proud to highlight a new AMIA program called High School Scholars: Building New Paths to Biomedical Informatics Education. This program encourages students at the high school level to participate in informatics research and development. Zeba Kokan, a student at Park Tudor School in Indianapolis (advised by Jon Duke), will present on Quality of Physician Documentation of Breast Cancer Family History.

Looking forward to a Regenstrief/IU/guests dinner at Petits Plats Tuesday evening to wrap up the Symposium while relaxing with colleagues, staff, and former trainees.

We are looking to recruit for several faculty positions, an assistant director of administration and a few system engineers within CBMI. We want to enhance the Regenstrief Institute’s leadership in Biomedical Informatics. You can help make that happen. Are you interested? For more information, please see the postings at http://bit.ly/RCBMI_OpenPositions.

Be sure to tweet about what is going on at AMIA: #AMIA2014 @RCBMI. See you there!

Help us improve healthcare … by joining the Regenstrief Team!

IMG_20130618_080807As some of you may know, the Regenstrief Center for Biomedical Informatics (CBMI) is recruiting for several faculty positions. I thought the new year might be a nice moment to tell you about the top 10 reasons to work at CBMI – and maybe get you or a colleague/friend of yours to check us out ;-). Even if you yourself are not interested in a faculty position here, maybe you know someone who would be. If so, please tell them about it!

  1. Improving healthcare is our heritage … and our future. Many people are familiar with the Regenstrief name in the context of informatics, but few are aware of our original roots in manufacturing. Sam Regenstrief, colloquially named the “Dishwasher King,” at one point produced 40 percent of the world’s Eskenazi Hospitaldishwashers. He got there through rigorous application of operations management and process improvement principles. One day, he had to go to (what was then) Marion County General Hospital (now Eskenazi Health) for a physical. What he saw in the crowded waiting room and elsewhere sparked the idea for the Regenstrief Foundation, which he endowed a short time later. Its mission: “to bring to the practice of medicine the most modern scientific advances from engineering, business, and the social sciences, and to foster the rapid dissemination into medical practice of the new knowledge created by research.” The Regenstrief Institute has stayed true to this mission since its founding. The CBMI supports this mission primarily through informatics and information technology research and development.
  2. We apply and evaluate informatics interventions in real-world settings. At CBMI, informatics is not just theory. We continually apply it in the real world. A strong and enduring (nearly half a century) partnership with Eskenazi Health has produced a long string of seminal advances in health information technology. In addition, our work with the Department of Veterans Affairs Medical Center, and four large integrated delivery networks with multiple hospitals and ambulatory care settings provide access to real-world clinical environments for conceiving, implementing and evaluating informatics solutions.
  3. Jeff Warvel and Gopher retirement partyRegenstrief offers a unique set of informatics resources. Here is a partial list of our core informatics assets and competencies:
    • the country’s largest health information exchange: The Indiana Network for Patient Care (INPC), established in 1995,  includes clinical data from over 90 hospitals, public health departments, local laboratories and imaging centers, and a few large-group practices. It is used by approx. 7,000 clinicians daily and carries over 4.7 billion pieces of clinical data for over 14.7 million unique patients.
    • The (new) Gopher: Built upon Regenstrief’s legendary Medical Gopher system, the new Gopher is a comprehensive computer-based physician order entry system. Designed by clinicians for clinicians, it is a platform for not only clinical data entry and management, but also for clinical decision support, electronic data capture for research and visualization of clinical data.
    • CareWeb: CareWeb is a Web-based results retrieval and reporting tool for clinical data from the INPC. Central Indiana clinicians access this system on average 200,000 times a day.
    • Data epidemiology: Through our clinical data repositories, we have extensive experience with the capture, curation, storage and analysis of clinical data.  These data have been and are a central resource for prospective and retrospective research, including clinical and pharmaco- epidemiology studies.
    • Interested in additional informatics research and application projects? Check out our Website.
  4. We live and breathe innovation: Our faculty innovate broadly across a variety of healthcare disciplines and domains. But, we do not stop there. Regenstrief has an internal Quarterly Innovation Challenge, open to everyone, which has funded over 15 projects during the last two years. Many of these projects are initiated by staff and several are on track to become fully-scale research projects. In addition, Indiana itself is innovation- and entrepreneur-friendly. BioCrossroads is a catalyst for the continued growth of Indiana’s robust life sciences industry. Among its many activities, BioCrossroads informs and educates; raises and invests venture capital funds in promising new companies; and builds business collaborations by bridging gaps across academia and industry.
  5. Explore exciting new directions with us. One reason I assumed the position of director of the CBMI are the vast potential opportunities that exist at Regenstrief. For me, the top ones include:
    • integration of genomic, proteomic and related information with electronic health records: Some people say “CPOE is so 20th Century.” For me, it is one of the continuing challenges in informatics. Think about this: The information that clinicians must take into account to make clinical decisions is growing day by day. New results from genetic and other tests, detailed data about a patient’s medication compliance, exercise habits, health literacy and environmental factors, and local population health trends – where does it end? CPOE and clinical decision support will become even more crucial to helping clinicians make optimal decisions in the future.
    • consumer health and personal health records: With the Indiana Network for Patient Care, we have a huge resource of clinical data generated in healthcare settings. However, BMI_pagethere is a large and growing complement of patient- (or people-) related data. Patient-recorded activity/exercise data? Glucose and blood pressure readings? Standardized assessments of average daily living functions? Much of these data can be highly valuable in healthcare and integrating them with the INPC would be a powerful combination.
    • data analytics and visualization: Data analytics has been one of our “bread and butter” activities for the last several decades. However, I think we can accelerate and be more efficient in how we create knowledge from the large databases we are sitting on. My boss, Bill Tierney, always says: “We could write thousands of papers based on the INPC data.” I say: “Ok, let’s do it.”
    • implementation science: The Regenstrief Institute and IU School of Medicine recently established the Center for Innovation and Implementation Science (CIIS), an organization dedicated to the development of methods to promote the systematic uptake of research findings and other evidence-based interventions into routine practice. Informatics tools are a key intervention and the CBMI is working closely with the CIIS to bring about real change in how clinicians practice.
    • cognitive systems engineering/human computer interaction (HCI): Those of you who know me will not be surprised that I am making this area a focus. Much of my own research has been on HCI aspects of clinical systems in dentistry. And, I have seen firsthand where approaches such as user-centered design and cognitive systems engineering can take us in terms of usefulness and usability of systems.
  6. Join a world-class team of faculty, staff and fellows. Many of our approximately 18 faculty are leaders in their fields/research areas, such as computer-based decision support, computer-based physician order entry, drug safety informatics, clinical data analytics, automated patient record matching, informatics standards, public and global health informatics applications, and dental informatics. Our faculty have a variety of backgrounds, such as internal medicine, medical specialties, dentistry, physical therapy, statistics and computer science. Five of our faculty are members of the American College of Medical Informatics and two of the Institute of Medicine. Two of our faculty, Clem McDonald and Bill Tierney, have received the prestigious Morris F. Collen Award of Excellence from the American Medical Informatics Association. Our staff consists of a dynamic and enthusiastic group of software engineers, database developers, project managers and administrative assistants. Recently infused with engineering talent from a variety of industries, our team possesses expertise in healthcare informatics; contemporary Web architectures, user interface and user experience methodologies; system integration; clinical decision support; and big data storage and retrieval. CBMI typically has between two and four fellows enrolled in its training program.
  7. Regenstrief is connected to Indiana University’s vast computational and academic resources. I have worked at two major universities (Temple and Pitt) and I am happy to say that every time I upgraded my experience with information technology support in academia. At Indiana University (IU), I have topped my experience to date. IU University Information Technology Services is a national leader in IT support among major universities, earning it a Computerworld’s 100 Best Places to Work in IT award in 2010 and 2011. Not only does UITS serve the everyday computing needs of the campus, it also supports research in and application of high performance computing, advanced networking and the evolving international cyberinfrastructure. Digital textbooks, virtual software delivery, and innovative learning environments support IU’s mobile students. IU is also a global partner in creating sustainable models for the collaborative development of teaching, learning, research and enterprise software.carnival
  8. We are a fun family. A lot of faculty and staff have commented to me that they like working at CBMI “because it feels like family.” Having been here for six months now, I have become part of that family. One of the best aspects of Regenstrief is that the kind of chasm between faculty and staff that you usually find in academia doesn’t really exist. Faculty and staff interactions are characterized by mutual respect, many close working relationships, a plethora of ideas and an easy, continual exchange. Plus, we know how to have fun! In the second half of 2013 alone, we had the Regenstrief Carnival, the RIFresh Initiative (which is, among other things, designed to inject fun into the workplace) and a wonderful holiday party.
  9. Indianapolis is a great place to live. I have lived in quite a variety of places in my life, ranging from Wildflecken, a small village in the Rhön mountains in Bavaria, to the metropolis of Philadelphia. I always had been wondering about what it would be like to move to the Midwest given the various comments I heard about it. I IMG_20130615_093039have to say I love it here. Indianapolis is a very compact and understandable city. It has a variety of interesting neighborhoods, plenty of great restaurants (some of my favorites include Bluebeard, Chef Joseph’s, Iozzo’s Garden of Italy, Meridian and, of course, the Rathskeller‎) and great cultural attractions. It is easy to get around – the local joke (essentially true) is that it is takes only about 20 minutes to go from anywhere to anywhere in Indy (ok, slightly longer on a bicycle). Of the nine miles of my bicycle commute, seven are alongside a canal and the White River. And, most importantly, the people are friendly and welcoming. One of our neighbors gave us a few home-cooked meals when we were moving in, a very welcome gesture. Another set of neighbors had a welcoming party in our honor.
  10. Make a difference … : We all know that the healthcare system in the United States is in deep trouble. We also know that informatics and information technology are two key ingredients in turning the situation around. We are looking for a few people who want to make a real difference. And, Regenstrief is one of the places where you can do that best!

Interested? Take a look at http://bit.ly/RCBMI_Faculty, and then send me email or give me a call!

Titus


Titus Schleyer, DMD, PhD
Clem McDonald Professor of Biomedical Informatics
Director, Center for Biomedical Informatics
Regenstrief Institute, Inc., 410 West 10th Street, Suite 2000, Indianapolis, IN 46202-3012
Skype: titus.schleyer, Ph: (317) 423-5522 (direct), cell: (412) 638-3581, E-mail: schleyer (at) regenstrief.org
Web: http://www.regenstrief.org/cbmi/, Blog: https://titusschleyer.wordpress.com, General: http://about.me/titusschleyer

Regenstrief CBMI goes to Washington …

Remember the old movie “Mr. Smith goes to Washington” with Jimmy Stewart? From November 16-20, the American Medical Informatics Association (AMIA) had its 2013 Annual Symposium in DC and Regenstrief Institute CBMI faculty, along with colleagues from other IU affiliates, “went to Washington.” This Symposium is the premier scientific meeting for biomedical and health informatics research and practice which takes place each year in the fall and brings together sterling informaticians from across the US and Canada, as well as many of our international colleagues.

The Symposium lived up to its – usually high – expectations as it has for the past 35 years. I might have been a little bit biased this year because I had the privilege of helping shape the program as the Applications Track Chair, along with Foundations Track Chair Katie Siek and SPC chair John Holmes. To increase program quality, we consciously lowered the acceptance rate to just over 30% from its more typical 40-43%. Together with over 2,400 attendees, we heard about conceptual and practical advances relating to biomedical information and innovations in design, technology, implementation of information systems and knowledge resources across the full spectrum of health care. Not only did we hear and learn about other’s advances and innovations, but we were able to share a few of our own with our peers.

Dave deBronkart (also known as e-Patient Dave), co-founder and board member of the Society for Participatory Medicine, gave an excellent keynote on Sunday about patient engagement in healthcare. He charmed informaticians with quotes such as “Come to the dork side. We have pi.” (That quote was just meant for Burke.) Dave even wrote a nice blog post about his experience at AMIA. From the attendee comments I heard as well as tweets about his talk, it appeared to be one of the most well-received keynotes ever given at AMIA. Even I was so taken in that I tweeted:

Pete Szolovits from MIT won the 2013 Morris Collen Award, a well-deserved honor (see the video here). For those of you who do not know much about Morris Collen, Bill Tierney wrote a very nice blog post about him on the occasion of his 100th birthday. Congratulations also go to JT Finnell, CBMI faculty member, and colleagues for receiving the AMIA Leadership Award for work on Advancing the Clinical Informatics Board Review Program. (Incidentally, JT was among the first people to pass the board exam the other day.)

After the opening session I ran a panel titled “Informaticians, CxIOs and Industry: Strengthening the Fabric of HealthIT with speakers Blackford Middleton from Vanderbilt, Bret Shillingstad from Epic and Marc Overhage from Siemens (my predecessor at Regenstrief). The panel presented viewpoints from key industry and academic leaders on strategies to improve informatics’ contribution to positive changes in healthcare. It was standing room only, and we had attendees from Epic, Cerner, Allscripts and many other HIT companies. One tweet from there that got a lot of attention:

AMIA’s Welcome Reception on opening day was held in the Exhibit Hall where Regenstrief Institute shared a booth with the IU School of Informatics. This was a perfect opportunity for AMIA attendees to visit the booths and ask questions of the exhibitors. Kudos to Emily Mitchell, our fellowship coordinator, for preparing for the exhibition, setting up the booth and staffing it!

Sunday evening was the American College of Medical Informatics (ACMI) dinner and new Fellow induction. I am proud to say that this year Paul Biondich, CBMI faculty, was one of the inductees joining Regenstrief ACMI fellows Bill Tierney, Steve Downs, Shaun Grannis and me. Paul’s accomplishment is even more noteworthy since he was one out of only six new inductees (of over 40 nominees) – making this ACMI election one of the historically most selective.

Monday our fellow Jianmin Wu presented a paper evaluating congruence between laboratory LOINC value sets for quality measures, public health reporting and then mapping the common tests. In the afternoon, investigators Shaun Grannis and Brian Dixon participated in a panel titled “How fit is electronic health data for its intended uses? Exploring data quality across clinical, public health and research use cases.” Concurrently, investigators Jon Duke and Burke Mamlin demonstrated an update on our Gopher Order Entry System for AMIA attendees. Regenstrief Investigators Brian Dixon and Shaun Grannis, and staff member Mark Tucker, presented a demo on The Regenstrief Notifiable Condition Detector, an automated public health reporting system using routine electronic laboratory data.

Tuesday IU colleague and Director of the Department of BioHealth Informatics at the IU School of Informatics Brad Doebbeling presented a paper discussing informatics challenges and strategies to prevent MRSA infections from a multihospital infection prevention collaborative viewpoint. Brad collaborated on this paper, which received an AMIA Distinguished Paper Award, with Abel Kho, former CBMI fellow, from Northwestern for several years.

CBMI investigators Brian Dixon, JT Finnell, Shaun Grannis, fellow Jianmin Wu and former fellow Jason Cadwallader also presented Variation in Information Needs and Quality: Implications for Public Health Surveillance and Biomedical Informatics, Opioid Abuse Risk Scoring within an Emergency Department, and A Practical Method for Predicting Frequent Use of Emergency Department Care Using Routinely Available Electronic Registration Data. Posters presented by Blaine Takesue, Brian Dixon, Josette Jones and some former Regenstrief fellows during the last two days of the meeting included:

• Health Literacy Redefined through Patient Engagement Framework
• Validation of Semantic Synsets in Natural Language Processing
• Patient, Caregiver, and Provider Perceptions of a Colorectal Cancer Personal Health Record
• Measuring and Improving the Fitness of Electronic Clinical Data for Reuse in Public Health, Research, and Other Use Cases
• Using SMART and i2b2 to Efficiently Identify Adverse Events
• Semantic Processing to Identify Adverse Drug Event Information from Black Box Warnings

Tuesday evening a large group of past and present Regenstrief folks embraced good food, a few drinks and a lot of conversation at a nice Italian restaurant, Bistro Bistro. It was great to catch with colleagues, staff and former trainees in a more informal setting.

Brian Dixon wrapped up on Wednesday with the inaugural and well-received “Year in Review for Public and Global Health Informatics.” The session reviewed recent literature in the areas of public health and global health informatics highlighting trends, knowledge, methods, and lessons from public health and the use of informatics in resource-constrained settings.

We have lots of hard work ahead of us to ensure next year we have even more new, exciting and innovative ideas that to showcase the Regenstrief Institute’s leadership in Biomedical Informatics. Are you interested in making that happen? We are currently recruiting for several faculty positions, ranging from the Sam Regenstrief Chair in biomedical informatics and a Chief Research Informatics Officer to midcareer and junior faculty positions. For more information, please see the postings at http://bit.ly/RCBMI_Faculty.

Thanks

Titus

PS Thanks to Sandy Poremba for helping put this blog post together.

 

What’s the organizational value of 40, 4,000 or 400,000 clicks?

The other day a seemingly trivial incident stimulated a discussion of how to increase process efficiency at the Regenstrief Institute’s Center for Biomedical Informatics. The original email I sent (see below) was entitled “Are process improvement and efficiency part of our culture?” (This was somewhat of a trick question.) Suffice it to say that I tried to highlight an opportunity for saving time for everyone by including an .ics calendar appointment with a broadcast email reminder of an upcoming event.

My point was that sending a reminder for an event that did not make it easy for recipients to act on it was not exactly pointless, but, well, inefficient. Of course, part of the thinking probably was: “This is just an informal reminder, so whoever wants to come probably already made themselves a calendar appointment based on earlier messages.” True. But, in our messy informational environment that the digital revolution has created it is usually not a good idea to rely on some item buried far down in our inboxes. And, in the larger scheme of things, why would I have to get a reminder anyway if I already put the event on my calendar?

The email below chronicles my futile journey across the organization’s information artifacts to see whether there was an easy way to put the event on the calendar. I ultimately did what most people in my position would probably have done first: turf the job to my administrative assistant Sandy (who, by the way, is a great help, for calendaring as well as otherwise). But, her time is highly valuable to the organization, also, and should not be wasted gratuitously.

So, what is the big deal? A few mouseclicks and keystrokes. To date, when I wanted to convert an email message to an appointment in Outlook, I pushed “Forward,” selected all text, dragged it onto the calendar, copied or typed the appointment subject, and entered date and time information. Had the original email included an .ics calendar file as an attachment, I would have double-clicked on that, pushed “Save” and I would have been done.  (Of course, receiving an Outlook invitation directly would have cut that down even further, to one click.) Total savings: about 15-20 seconds.

Let’s say I do 20 tasks like this per day, at a cost of 20 seconds each. And, let’s say that that is true for the roughly 100 employees of BMI. That means that we collectively waste 400,000 seconds (or roughly 110 hours) a year (20 seconds x 100 people x 200 workdays/year). If we budget $100 as an average hourly rate across the organization, we are talking about $11,000. This may not sound like much, but is just the tip of the iceberg in terms of how inefficiencies inherent in or resulting from information technology drain our productivity.

As soon as I sent the email message below to all faculty and staff, two things happened: (1) People agreed with me that this was an important if largely invisible issue. And, (2) they started sharing all kinds of productivity tips related to appointments in Microsoft Outlook. From those tips, I learned how to:

For me, that sequence of events begs two major questions:

  1. How do you encourage organization-wide thinking and behavior about process improvement?
  2. How do you efficiently share everyone’s knowledge of the little tips and tricks that help you become more efficient?

Regarding (1), I thought that would be a non-issue before I took this position. From my original email:

“From what I read about the history of Sam Regenstrief, I understand that one key to his success in capturing 24% of the total dishwasher market in the United States in 1970 (see the book) was his relentless focus on process improvement and efficiency.”

So, I am thinking: “This is the Regenstrief Institute – they MUST be doing what made Sam Regenstrief great.” Wrong! The more I learn about our Center and the Institute, the more I realize how far we have strayed from our original philosophy. I could write a whole stack of Harvard Business Review Case Studies about our opportunities for process improvement.

Regarding (2), this is a tricky problem that several decades of research in computer-supported cooperative work (CSCW) have so far failed to solve. Judging from the literature, the answer is not just a software application that facilitates tip sharing. Succeeding with organizational knowledge transfer most likely requires a complex amalgam of culture, education, individual and group behavior, as well as technology. Which places have succeeded in this? What organizational development interventions are particularly effective? Are there useful software applications out there for this? Please write to me with your ideas and I will try to implement them here. I will let you know how it goes.

Thanks in advance!

—————————————————————————————————————————————–
Original email message
From: Schleyer, Titus K
Sent: Tuesday, July 02, 2013 5:40 PM
To: mi-staff-l@list.regenstrief.org
Subject: Are process improvement and efficiency part of our culture?
Hi everybody,

The other day, I had a simple problem in putting an event on my calendar which was easily fixed. However, in the larger picture, it is a good example of how suboptimal processes sap our resources in (often invisible but substantial) ways every day.

The event in question is the Quarterly Innovation Challenge on Friday, August 9th from 1-3pm in HITS 1110. I was wondering whether it already was on my calendar since I intend to participate. It wasn’t, so I went back to Jon’s reminder email from 6/27/2013. The email was not in the form of a calendar invitation and also did not include the event as an iCalendar attachment.

Of course, I could have just dragged Jon’s email on the Outlook calendar, used copy and paste a few times, and be done with it. However, I wanted to see how difficult (or easy) BMI would make it to get this appointment onto my calendar. So, I went to the Intranet, where I remembered seeing a calendar. I navigated to 8/9/2013 and – lo and behold – this event was (and is) not on there.

So, I got a cup of tea and inspected the poster about the Innovation Challenge on the way. I thought maybe it would contain a QR code that I could scan with my tablet, and maybe I could get to the appointment that way. No QR code, however.

In the end, I just forwarded the email to Sandy with the request to put it on my calendar. Most people probably would’ve said that that’s what I should’ve done in the first place. But, Sandy has better things to do than completing the non-value added task of adding something to my calendar.

I think there is a larger lesson in this trivial event. From what I read about the history of Sam Regenstrief, I understand that one key to his success in capturing 24% of the total dishwasher market in the United States in 1970 (see the book) was his relentless focus on process improvement and efficiency. So, I am a little bit surprised that we do not live and breathe his philosophy more than we do.

Ideally, I should have been able to put this appointment onto my calendar with one or two (double) clicks from any of the places I mentioned. Try it! Double-click on the attached file and push Save & Close. Done! (I look forward to seeing you there!)

Some people may argue about debating the value of a click. But I’m not debating the value of a click. I’m debating the aggregate value of thousands of extra clicks per person per year at our Center. I am debating the value of thousands and tens of thousands of non-value added tasks that break up our ability to get real work done. Those things have a real cost, even if they don’t show up on a balance sheet.

If we want to keep the legacy of Sam Regenstrief alive (and I think we should), we need to live and breathe his philosophy. Process improvement and efficiency must become our way of thinking, deciding and acting.

With that, I am off to kendo!

Titus

Titus Schleyer, DMD, PhD

Clem McDonald Professor of Biomedical Informatics

Director, Center for Biomedical Informatics

Regenstrief Institute, Inc., 410 West 10th Street, Suite 2000, Indianapolis, IN 46202-3012

Skype: titus.schleyer, Ph: (317) 423-5522 (direct), cell: (412) 638-3581, E-mail: schleyer@regenstrief.org, Web: http://www.regenstrief.org/cbmi/, http://about.me/titusschleyer