The Perfect Storm for Innovation

In my career, there have been a few perfect storms, defined as "a confluence, resulting in an event of unusual magnitude".

When I was an undergraduate at Stanford University in 1980, two geeky guys named Jobs and Wozniak dropped by the Homebrew Computer Club to demonstrate a kit designed in their garage.   IBM introduced the Personal Computer and MSDOS 1.0.   I purchased an early copy of Microsoft Basic and began creating software in my dorm room including early versions of tax calculation software, an econometric modeling language, and electronic data interchange tools.   Every day brought a new opportunity. The energies of hundreds of entrepreneurs created an industry in a few intensely creative months that laid the foundation for the architecture and tools still in use today.   A guy named Gates offered me a job and I decided to stay in school instead.

In 2001 when I was first hired at Harvard, a visionary Dean for Medical Education, a supportive Dean of the Medical School,  talented new development staff, and a sleepless MD/Phd student came together to create one of the first Learning Management Systems in the country, Mycourses.   Robust web technologies, voice recognition, search engines, early mobile devices, and new multi-media streaming standards coincided with resources, strong governance, and a sense of urgency.  Magic happened and in a matter of months, an entire platform was created that is still powering the medical school today.

At BIDMC in 2010, IS Clinical Systems staff and key operational leaders realized that Meaningful Use Stage 1 was within reach if we temporarily put aside other work and focused our energy, creativity, and enthusiasm on rapid innovation, process change, and education.   In a few weeks we became the first hospital in the country to certify our EHR applications - inpatient and ambulatory.    We became the first hospital to achieve Meaningful Use.  More than 70% of our eligible professionals have surpassed meaningful use performance thresholds.   We had no budget, no dedicated resources, and nothing but strength of will to make it happen.   It was one of our finest hours.

In 2011, the Massachusetts public sector (Secretary of EOHHS, CIO of EOHHS), private sector healthcare leaders, and healthcare IT experts had a bold idea - create a public utility that links together all the existing regional health information exchanges, public health, small clinician offices, payers, and patients using modular components procured and initially operated by state government.   We aligned forces and in a few weeks created budgets, project plans, a new State Medicaid Health Plan, and a guiding coalition of stakeholders.    Political, organizational, and technical barriers were broken down and unbridled optimism rekindled our health information exchange momentum.    2012 will be a transformative year in the Commonwealth, truly a perfect storm.

My advice - look for the perfect storms in your own life.  Minimize your distractions, cancel unnecessary meetings, and put aside those tasks that don't add value.   Take a risk and dive head first into the possibility of creating greatness.   I've seen opportunity come and go in my life.   No one remembers the mundane.  No one forgets the events of unusual magnitude.

Recently, I updated my BIDMC job description to include fostering healthcare information exchange among affiliates, accountable care organizations, and the community.   The Massachusetts Health Information Exchange is the next perfect storm in my career and I will devote all of my energies to the confluence being created by EOHHS CIO Manu Tandon, Massachusetts eHealth Collaborative CEO Micky Tripathi, and the dozens of volunteers lending the wisdom to the process.