Tag Archives: data

Notes on Dr. Atul Gawande’s talk at the Health Data Palooza [LIVEBLOG]



[Editor's note: these are live, rough notes from my iPad, and should not in any way represent a 100% accurate transcription. I missed far too much. Caveat lector. My comments are in brackets. You can find Dr. @Atul_Gawande's bio & writing at the New Yorker. Update: I've posted video of Dr. Gawande below.]

GAWANDE: A fascinating part [of the Health Data Palooza]: the idea that we’re putting together people from government, healthcare systems, people from outside who have knowledge about data and tools. This is quite different from the normal models: regulatory or laissez faire.

We have a healthcare system that’s fundamentally broken. The most common complaints from patients seem to be no one you can count on. If you’re paying, you have no sense that there is anyone who can help it costs be under control.

Where to start to fix that? We have recognized that there is enormous variation in cost, depending on whet you go. There is enormous variation in cost, depending on where you go. The two don’t have anything to do with one another. So there’s hope. [Good news.]

Some of the best places to get care are the least expensive. [In healthcare,] positive deviants are the ones that look the most like systems.

Examples from war and lessons within lethality

GAWANDE: Start by looking at performance of doctors in war and their teams. In the war in Iraq/Afghanistan, lethality below 10%. That doesn’t reflect intensity of conflict but improvement in care.

How did we do it? It was the not discovery of new tech that transformed survival but ability to use existing tech far better, in a system that works.

1) Kevlar. Got soldiers to wear it, operationally.
2) Speed to operating table. Improved forward mobile operating theaters.

We achieved the best survival rates in history. How? They changed the way they did surgery. Looked at data, realized needed to stop bleeding, stop contamination, under resource restrictive conditions. No X-rays, needed to learn 19th century techniques for finding fractures by feel.

They adopted “damage control surgery”: Do what you could during 2 hours. Ship and add a note: here’s what I’d did, what’s needed. That helped stimulate development of simple EHR. Average time from wounded on the battlefield, to getting care in the field, Baghdad, in Germany, in us, is less than 3 days. Less than 36 hours for some.

Soldiers can find better care for some conditions in Iraq than in a US city, with fewer resources. How? Alignment of finances, incentives. They weren’t “fee for service soldiers.” Everyone is on the same team: focused on saving life, maintaining health.

Within 48 hours of the wounding or death of soldier, posted on the DoD website. [DCAS: Defense Casualty Analysis System] The public accesses that data, but doctors & nurses access it the most.

One more example: soldiers not wearing protective eyewear. They called them ‘Granny goggles.’ The DoD contracted with a designer, made cool ones. Now wearing. Needed data and research to understand. [Stories matter.]

Affordable Care Organizations (ACOs) have done financial alignment. They’re committing to doing more project at a time. They’re committed to better health within an environment.

To get there, folks in war needed data useful to frontline decision makers. [The same is true at home.]

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My Poynter Institute presentation on open data journalism

This week, I’m down in Florida at the Poynter Institute as a “visiting faculty member,” talking about social media and politics. My first presentation, embedded below, was on the promise of open data journalism.

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Considering Disasters, Social Media and Crisis Congress at FEMA

 [#Gov20]

Filtering facts from dross is doubly important during a time of war, 
which is a critical frame for discussing Wikileaks, open government and new media hurricanes. It’s also true during hurricane season, when accurate
 reporting of storm tracks, damage and conditions is crucial. A 
capacity to maneuver more effectively in the most elemental of
 environments will be useful in 2010 and beyond.

One place that’s happening is at the top of the
 Federal Emergency Management Agency, where FEMA Administrator Craig 
Fugate has been leveraging technology to more effectively deliver on 
his mission.

While FEMA has taken tough criticism over the years, its current administrator brings a common sense approach and deep experience from his work in emergency management in Florida.

Last month, Fugate talked frankly the first “Crisis Congress” about social media, disasters and the role Crisis Commons and civil society efforts could play in crises.

There are 
good reasons for that conversation. According to Fugate, ESRI built 
the ability to add Open Street Map as a layer after watching their
 work crisismapping Haiti.

He also highlighted the Crisis Commons Oil
Reporter app as a prototype of the kind of robust app that could
 integrate FEMA open data.

“We work for the people, so why can’t they be part of the solution? “
said Fugate to the assembled Crisis Congress. “The public is a resource, not a 
liability.”

As a recent example, Fugate said that FEMA used reporters’ tweets during Hurricane Ike for
 situational awareness. “We’ve seen mashups providing better info than
 the government.”

Fugate has been out in front in leading an agency-wide effort to enable information and 
e-services to find citizens where they are, when they need to access it. For instance, a new mobile FEMA.gov allows citizens to apply for 
benefits from a cell phone.

More features are on their way to 
mobile platforms soon, too, according to Fugate. “I want an app on multiple platforms that knows
 where my phone is,” he said.

For more on what’s happening with FEMA in this space, read about last week’s Emergency Social Data Summit in Washington from the Red Cross or Voice of America or watch Craig Fugate talk about social media at InCaseOfEmergencyBlog.com.

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