The WIHI chat room

A picture of Madge Kaplan from the set of the WIHI webcast below, along with some comments from the chat room. The topic was mainly this blog. While some comments were directed to me, others were going back and forth among the listeners. There was not time to reply to all questions, but to hear my answers and the whole thing, check the podcast available here sometime on Friday.

Moulay Alaoui: In this era of transparency in health care and trend of patient demand, it is very relevant. However, it is very courageous of you to use this medium.

Denise Vincent: Oh gosh yes, the EPA makes water treatment plants send an annual report to all customers.

Cristina Wilhelm: The blog makes me think of the Wizard of OZ...the curtain has opened and everyone can look in. Kudos to you for opening the curtain yourself.

Pamela Ressler: Communication is essential in healthcare, but often we are afraid of it -- and it does take courage and vulnerability to put yourself out there, as Paul has done so well through his blog.

Mary Ann Bone: Has your legal department responded to your blog?

Sandra Snider: I've been afraid to blog too much about work for fear of getting in trouble.

Brian Yanofchick: Apart from a legal department's predictable issues, how have other staff, such as physician, nurses, others responded?

Maureen Watchmaker: I am a nurse case manager who has been at BIDMC before and after Mr. Levy's arrival (since 1999). To answer Mr. Yanofchick's question, from listening to colleagues, the overall response (including my own) started as suspicion, moved to incredulousness tinged with hope and now has become an attitude of "of course this is should how a CEO should behave." Now, as times become tough, most of us feel hopeful with Mr. Levy at the helm. With the SEIU circling our hospital, I think that his transparency has been one of the factors that have kept them out.

Brian Yanofchick: Thanks for that response. Very helpful. I'm not surprised by the initial worry, but heartened that staff have begun to see it as a plus.

Shawna Willcox: Maureen, what is the SEIU?

Maureen Watchmaker: Shawna-It is a very aggressive union that has targeted BIDMC.

Lawrence Van Rossum: Question: Do you think Hospitals need to take a serious look at the Process of Patient Care and Clinician work flow in order to achieve a better level of service and harm less patients?

Charles Lee: You mentioned medicine is a "cottage industry". Is this changing with government, hospital corps, PPOs, HMOs, etc. becoming more and more the norm?

Aline Gonsalves: Unless you learn to blog and be more open in all communications (whether clinical or other), as long as privacy laws are not violated, it is crucial this type of blogging become part of organizations' daily running or our teenagers will make it so in the near future. It's crucial CEO's learn how to do this as soon as possible before they are forced to. Blogging and internet network are tools for enabling, not destroying.

Moulay Alaoui: Great point! Healthcare provision quality is central and it is mainly about processes not persons. Standardization is an ultimate goal of this industry, especially within a system (a conglomerate of providers).

Ann Bailey: How have patients/community responded to the blog and outcomes data? Are you getting any feedback? Some organizations report that patients/potential patients may not understand what the data says or how they might use.

Dave Weinstock: Do physicians need to be salaried and work for the hospital to help standardize (as an organization versus a collaboration of individual contractors)?

Doug Bonacum: Have you had any malpractice allegations brought against BID where Blog / Website information was used against you?

Brian Yanofchick: Communication methods like this are a great opportunity to positively change a culture from one of paternalism to one of true accountability.

Sandra Snider: I'd rather post our outcomes data than have Healthgrades post data that is years old.

Daniel Grigg: I'm wondering how much time it takes to do the blog each day. Once you begin, it's a pretty serious commitment to keep up with it.

Madeleine Girard: If an organization is truly transparent, the "need to know" attitude disappears. And all the fears and worries that come along with it.

Daniel Roy: In dealing with healthcare professionals, the mentality has always been that they are behind the times...presumably because of the fear of change and risk of increasing liability. I applaud you for taking a leap to change that perception.

Madeleine Girard: I agree with you Daniel. A huge culture change is happening in my workplace with a new CEO at the helm. His style reflects Mr. Levy's though he is not yet blogging... Something to suggest at our next meeting.

Sandra Snider: If the public knows you use mistakes in a positive way to improve care and prevent future events, they will be more likely to forgive us our mistakes.

Nick Dawson: Is there something unique about healthcare that lends itself to "social media" - its a topic that is much hotter than social media in other industries from John Lockhart to All Participants:I am a hospital board member studying the new IRS form 990. Will you discuss executive compensation issues on your blog ?

J Zuercher: Healthcare impacts everyone!

Aline Gonsalves: It's about connecting as people.

Pamela Ressler: And communication allows for more effective collaboration -- provider/patient, leadership/staff.

Maureen Bisognano: In this day and age, leaders need to use all methods of communication to reach the many audiences they need to connect with...we are in a time of "continuous partial attention" (Tom Friedman), and we know that people learn and contribute in many ways. You reach them all!

Aline Gonsalves: As a business consultant in healthcare, it's important to realize it's crucial impact on accountability frameworks within healthcare. It helps surface assumptions that exist in healthcare. With the "accuracy" of internet medical information, assumptions are made that can result in wrong decisions. Blogging and internet networking can clarify misconceptions.

Ron Ferrand: Is there a recording of this webex available?

Jesse McCall: Recording available at: http://www.ihi.org/IHI/Programs/AudioAndWebPrograms/WIHI.htm?TabId=14 by tomorrow.