Where we were–
Just 4 years ago, I was completing my internal medicine residency at Georgetown University Hospital in Washington, DC. Every morning, I would round on about 20 patients. And I know that most patients complain that they only see the physician for about 10 minutes, and it’s way too early for them to have a conversation. What they don’t know is that before I would step into the room to find them, I had to track down the paper chart with their vitals, then another paper chart from someone else with the medication distribution list, and finally another paper chart with notes from overnight. If I was tired after this, I would usually attempt to track down the nurse to ask if there were any complications overnight. This process took about 20-30 minutes of super fast walking, ducking, poking my head up, asking if so and so had seen the chart, and then quickly redirecting my search.
Just two years ago, Massachusetts General Hospital rolled out the Apprentice program midway through my fellowship. This program allowed me to have an electronic list of my patients with electronic updates from overnight AND created my progress notes pre-populated with the medication list and lab results. Prior to this, we were writing the entire note by hand. AMAZING. This shaved off 2 hours of work a day, while I was seeing 15-30 patients.
In my interview with Dr. Michael Docktor, the physician lead of the Hacking Pediatrics Executive Team, last week, he notified me that Boston Children’s Hospital was getting ready to release a program that allows the downloading of a HIPPA-compliant secure app to your phone that then acts as a pager with instant messaging capabilities. FANTASTIC! I think all residents have had that day when they received so many pages that they just stood in one place for 4 hours next to a phone returning pages. And by the time you returned half of them, the person on the receiving end had left their phone station or were very angry.
Yesterday, Dr. Naomi Fried, chief innovation officer at Boston Children’s Hospital, did an interview with Information Week. She said that “necessity has been the mother of invention in pediatrics for a long time.” The article goes on to say that Boston Children’s has a long list of innovation initiatives, ranging from seed funds for innovators to apps developed in-house for patients and their families to navigate the hospital.
Clearly, we’re seeing a celebration of Boston’s Children’s Hospital innovation with their Hacking Pediatrics Hackathon scheduled for next week.
Are physicians slow to embrace change? Why don’t we see more physician entrepreneurs? I think part of this answer lays in the response that Dr. Usha Periyanayagam, Fellow in International Emergency Medicine at Brigham and Women’s Hospital, gave me this week. She said, “That’s the nature of venture and innovation. You’re finding answers to important questions, and that’s exciting and meaningful. But the failure rate is high. Doctors aren’t comfortable with failure. They aren’t comfortable with failure being okay. When’s the last time I failed something? I’ve taken multiple tests, and I’ve always passed with high ranking scores.”
My passion is healthcare optimization, whether that is with innovation, making scientific discoveries, or improving delivery. I love bringing people and ideas together and making projects work. With this, medicine exists to improve lives, and I will strive to always help patients and those around me.
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