Edelmen the linchpin for the Patriots

Written off before the season started because of the loss of most of their secondary, then again with the injury devastation to their front line, the NE Patriots managed to make it to the AFC Divisional Championship game. They are able to adapt to their losses: Dion Lewis is out for the season, we'll move LeGarrette Blount up, lose Blount, we'll use the passing game.  

That all ended with the loss of Julian Edelman.  Football is a true team sport.  No single player cannot do it alone.  But sometimes there is a linchpin player, and without him, the team suffers.  With the running game gone due to injury, they went to the air.  But without Edelman, they were as successful.  Because other teams could focus on Rob Gronkowski and Danny Amendola.  And while The Gronk is a dominant player but he is the 2nd or 3rd man in coverage.  He doesn't have the quick moves to get away as quickly underneath as Edelman and that extra time Brady has to hold the ball is all a good defense needs.

It was an surprising to me to realize how much Edelman means to this team.  Although, it's probably good for his contract negotiations.

Are You Really Sure You Want To Do That...Too Many Wasted Clicks

I sometimes wonder who is in charge of adding extra clicks to tasks and if they get paid by the click.  You see it everywhere.  I notice it on my GPS (I am old enough to have a GPS beside my phone).  To do a simple task, such as cancelling my route, i click to bring up the cancel screen, select cancel route, confirm I want to cancel my route, and then am brought to a black screen where I must say 'Done' before I can get back to the maps. We have all had this experience as technology is everywhere and not always well designed.

EHRs are notable culprits of the dreaded extra click.  They are usually of the program-minded, 'Are you sure you wish to....'.  There are ways to deal with this extra step, either making the click easier and faster or eliminating it entirely when it is not necessary.

Then there are the multiple steps that can be combined into one.  A big example of this is Save.  Most of the time physicians whether writing a chart note, interoffice note, consult note, etc want to save the note to the chart and perform another action...Print or Send.  In many EHRs, physicians need to save their work, then reopen the chart, go to the note and the print or send.  This time waste, is frustrating and unnecessary.  A simple change to the UI (user interface) and you have a Save and Print button or a Save and Send button.


These changes take very little programming resources.  They only require a little bit of forethought, or listening to your physician clients' feedback.  It's out there.  Take the time to listen.

EHR features and their hidden cost

Everyone loves new features and in the EHR industry, they are often required.  Whether the new EHR features are for Meaningful Use, Quality Measures, or Surescripts new requirements and the drive for new features keep coming. 

In programming, new features often come at a price.  That price is often in the physician's workflow.  Whether the new features add more steps (more clicks) to an already burgeoning list of things he/she has to do, or those features slow the system down.

As Steve Jobs said, people don't know what they want until you give it to them. Doctors like all the features that come with some of the large EHR systems, but when using EHRs, they want speed.  They have limited time with their patients and don't want to use it inside an EHR. 

There are two places that EHRs can improve speed.  One is at the code level.  Making sure their code is updated, works well with new additions, is on a strong platform, and with optimize database management.  This help with the spinning wheel when waiting to go from one screen to the next.

The other way is often over looked.  And that is work flow.  How do doctors think and how do they want their charts to look and feel.  Is it intuitive and does it use the least number of clicks.  This is where most EHRs fail their clients.  And until this becomes a top priority, the true benefits of EHRs for physicians cannot be realized.

Paint Colors and EHR Interoperability

As some of you may know, i have been building a cornhole set (bean bag toss game) for tailgating at the New England.  When it came time to paint the set with the Patriots logs, i looked up the color scheme online.  There were a number of standardized color formats (HTML, Pantone, RGB, etc) to get the accurate colors for the logo.  But  when i went to Lowe's to get the paint, i was told none of that mattered.  No paints are standard, so each red, green and blue are different.  Not even white is standard.  

While this was a frustrating experience, it was only paint.  With EHRs this lack of standardization can lead to poor patient care and increased medical expenses.  Whether it is the ability to see notes from specialists,  ED visits, or medications added by an urgent care visit, if the physician can't see the information, patient care can suffer.  

EHR interoperability requires a standard language for EHRs and diagnoses.  ICD-10 is a big step in the right direction for diagnoses. With a standard set of diagnosis codes, EHRs and HIEs can better talk with each other leading to better interoperability.  But that will be only the first step.  EHRs need to be able to communicate better with each other and until they do, full interoperability will not be achieved.

Building a cornhole set (a bean bag toss game)

I learned from my step-sister, Cara, that the bean bag toss game we see when we tailgate is called a cornhole.  Not the term I expected, but it comes from the fact that the classic bean bags are filled with corn (often feed corn).

I have begun building a the ramps you play with (and will likely purchase the bags).  My wife and daughter will be painting the New England Patriots logo on the game set.

I am using the instructions at This Old House.  I like This Old House and I liked that they suggested a handle for easy carrying.

Building a cornhole... http://www.thisoldhouse.com/toh/how-to/intro/0,,20397259,00.html

Learned the bean bag toss game was called a 'cornhole' from my step-sister Cara. Will update with pictures as i go.

A Fistfull of Slugs

I enjoy my time working in the garden.  I like tilling, planting, watering, and especailly enjoy harvesting.  I even like weeding (to some extent). 

This year, I have been having trouble with my Bok-Choi leaves being eaten to shreds.  And yesterday I found the culprits. 

Needless to say, my wife was a bit grossed out by the picture...