Everything worth winning in life boils down to teamwork and leadership. In my positions as a businessman, athlete, community leader, and University trustee, there are tremendous parallels between all of these endeavors that mirror an extreme team sport such as medical technology. Understanding the game, defining the game, playing your position at your highest performance, and helping others play their best game. Advanced Health Technology represents an incredible opportunity to level up the game of healthcare and highlights the multiple disciplines – or positions to be mastered – while laying out winning plays to make that next level happen.
Ronnie Lott, Managing Member, Lott Investments; Member, Pro Football Hall of Fame, and Trustee, Santa Clara University
Healthcare stakeholders are paralyzed from making progress as risks explode in volume and complexity. This book will help readers understand how to manage and transcend risks to drive the quadruple aim of improved patient experiences, better patient and business outcomes, improved clinician experience, and lower healthcare costs, and also help readers learn from working successful examples across projects, programs, and careers to get ahead of these multidisciplinary healthcare risks.
Table of contents :
Table of Contents
About the Editor
About the Contributors
Part I Tackling Barriers to Rapid, Exponential Acceleration of Advanced Technologies in Medicine
Chapter 1 What to Know about Data Transformation for Advanced Technologies in Medicine
What Is Data Transformation?
Data Transformation in Healthcare
EMRs and EHRs in Transforming Data
Definitions and Terms
Need for Data Transformation in Healthcare
Where Quantum Computing Can Make a Difference
Cybersecurity and Quantum Technologies for Healthcare
Chapter 2 Closing Knowledge Gaps, Critical in Advanced Technology for Medicine: Building Shared Knowledge to Drive Down Risks in Medical Technology
Technology Integration and Interoperability
Knowledge Gaps across Cultural and Geographical Diversity
Reducing Risks in Healthcare
Knowledge Transfer – Use Case/Example
Space Shuttle Challenger Accident – Results of Failed Knowledge Transfer
Swim Lanes (or Building Team Alignment and Synergy)
A Cognitive Approach to Understanding and Motivating Knowledge Sharing
Interoperability and Technology Integration – What Is the Purpose of Interoperability in Healthcare and Do Knowledge Gaps Affect It?
What Role Might AI Play in Reducing Knowledge Gaps? Artificial Intelligence (AI) in Reducing or Widening Knowledge Gaps
What Is Experiential Knowledge?
Summary – Human Experience and Knowledge
Terms and Definitions
Chapter 3 Tech Misinformation and Medical Misinformation as Evil Twins: The Misinformation Path to Destroying Trust in Medical Technology
Identifying Misinformation = Distrust
Examples of Gaps between Tech and Medicine
An Excerpt by a Systems Engineer for Systems Engineers: A Call to Protect the Public
Hierarchy of Medical Misinformation
Hierarchy of Tech Hype Misinformation
When Dogma and Physics Collide to Kill: Why Many People Don’t Know That COVID Is Airborne
Next Steps: Team Training to Bust Medical (and Medical Technology) Misinformation
Part II Management and Leadership Competencies and Objectives for Driving the Science, Medicine, and Engineering of Advanced Medical Technology Forward
Chapter 4 Allyship in Reducing Medical Technology Risk: Why Partnerships Are Vital to Your Professional Success
Aligning Allies with Reducing Risk and Increasing Success
Pros and Cons of Allies
Evidence That Ally Relationships Work
Recognizing, Recruiting, and Empowering Allies
Putting Myself in the Shoes of a Leader Looking to Learn How to Recognize a Solid Ally
Methods for Recruiting Desired Allies (And Yes, Some Allies Might Not Be Desired)
Establishing a Model That Promotes and Strengthens Allies
Allyship Competency Checklist
Paying It Forward as an Ally, Mentor, and Role Model
Ignorance Might Be Bliss
Recognize and Own Our Behaviors
Manage Our Behaviors
Holy Grail – Strategizing Your Impact and Scale: Assessing Potential Partner Service Organizations
Chapter 5 Extinction Is Eminent without Effective Transformational Leadership: Closing Leadership Gaps That Prevent Execution
What Is Transformational Leadership and Why You Should Care?
Desirable Personality Traits
Distinct Leadership Styles
Superbosses: What Are They?
How Transformational Leadership Helps Mobile Medicine and Other Advanced Technologies Succeed
Key Transformational Leadership Traits You Can Implement
Build People and Teams
Lean into Humility
Know What Makes an Effective Executive and Be Honest about Your Gaps
Take Responsibility for Tackling Conflict and Using It as a Tool for Improvement
Make Sure You Understand What Delegation Really Is
Close Gaps between Visions and Execution
Case Study: Transformational Leadership in Action
Building the Team
Aligning Team Values and Establishing Culture
Team Goal Setting
Team Outcomes and Experience
Chapter 6 Ignore the Dangers of Hubris at Your Own Risk: Mitigating the Barrier to Trust and Respect for High-Performing Teams in Medical Technology
Consequences of Hubris
Collaborators, Partners, Teams, and Organizations
Business, Industry, and Society
Person to Person
Leadership Selection, Performance Management, and Development
Culture, Community, and Organizational Citizenship
Chapter 7 Humility as a Core Value for the Adoption of Technology in Medicine: Building a Foundation for Communication and Collaboration
Humility in Medical and Technical Education
Moving from Expertise to Master Adaptive Learning
Humility in Technical Education and Culture
Humility as a Foundation for Communication and Collaboration
Integrating Humility into Communication
Communication Styles that Challenge Humility
It Starts at the Top
Leadership Hubris and Situational Narcissism
Interface of Technologists and Care Providers – Why Humility Is Critical
How Can Technologists Bring Humility to Clinical Users?
Risk and Humility in Healthcare Systems
Humility, Transparency, and the Acknowledgment of Error
Personality Factors and Medical Error
Humility as a “Use Case” for Technology Implementation
Humility and Technology as a Physician Leader
Humility Approaching Medicine as a Technology Expert
Humility in Technology Implementation by the Hospital Executive
Chapter 8 Burnout in Information Security: The Case of Healthcare
What Is Burnout?: A Basic Background
What Is Burnout?
Why Do We Care?
Understanding Information Security Pressures
How Is Information Security Different?
Why Are We Discussing Security as an Example?
Psychological and Economic Factors – How Does Our Business Culture Encourage This?
Psychological Root Causes
Hegemonic Masculinity and Homophily
How Does This Relate to Hero Worship and Hustle Porn through Storytelling?
What Have We Built?
Operating Systems Don’t Multitask Well, and Neither Do We – How We’re Like What We Create
We Assume a Perfect Communication Environment and High Signal-to-Noise Ratio
Isolation – How Virtually Isolating Team Members Causes Paranoia
Neurodivergence and Masking Drains Energy
Our Actions Reduce Energy and Make People Susceptible to Addiction
How Does Software Development Relate?
What Are the Economics behind This?
How Do We Misuse Metrics?
How Do We Start Down the Right Path?
How Do We Do This Right? How Do We Resolve These Issues?
Protection and Environmental Considerations Framework
The Roots of Burnout
What Can You Do for Others?
Conclusion – We Can Do Better, One Step at a Time!
Part III How Cybersecurity Enables Deployment of Advanced Technologies
Chapter 9 Security Frameworks as a Foil for Larger Management Issues
Dismantling the Definitions of Frameworks
Fraud, Fabulists, and the Blockchain – Why Tech Will Never Replace Professional Organizations
A Sputnik Moment
A Modern-Day Guild System
Shedding the Expense Item Mindset
The Lack of a Security True North and Supporting Programs
Understand Organizational Goals and Strategies
Mind Your P’s and C’s!
What Signals Are We Sending?
Management Past the Book – What the Thought Leaders Didn’t Tell You
Where Do We Start?
The Digital Transformation Meta Framework (DTMF)
HIMSS Electronic Medical Records Adoption Model Capability Levels
Choosing an Architecture
Leveraging Use Cases to Identify and Score Potential Failure Points
How Do We Track This?
What Do We Get from Using the DTMF?
What Do We Have to Do After?
Chapter 10 Managing Third-Party Risk: Framework Details for Risk Management in Medical Technology
Why Are We Here?
Evaluating Architectural Fit and Integration
Evaluating Actual Operational Work Involved
The Difference between Monitoring and Participation
Finding the Right Guidance
ISO Information Security Management Standards 27001, 27002, 27017, 27018
ISO/IEC 27018 – Public Cloud PII Protection
ISO/IEC 27017 – Cloud Services Security Controls
Certified Vendors ISO 17021, and Separation of Duties
American Institute of Certified Public Accountants/Service Organizational Controls Reports
NIST Cybersecurity Framework (NIST CSF)
CSA CCM, CAIQ, and STAR Registry
CURES Act and HITECH Certification Requirements
What Does This All Mean?
The 405(d) Program and Healthcare and Public Health Sector Coordinating Council (HSCC) Cybersecurity Working Group (CWG)
Policies, Standards, and Procedures
Third-Party Contracting and Risk Management
Chapter 11 Hospital at Home: Managing the Risks of Delivering Acute Care in the Patient’s Home
The Trend and Importance of Acute Care Delivery at Home
The Security Is the Tricky Part
The Do’s and Don’ts
Hospital Grade versus Consumer Grade
Part IV The Practical Technical, Legal, Management, and Leadership Steps to a More Interactive Health System
Chapter 12 Mitigating Value Risk in Innovation: A Physician Product Design Expert’s Lessons Learned Driving Clinical Product Development
Current State of Innovation in Many Organizations
You Can Only Rely on Uncertainty
There Are as Many Approaches to Innovation as There Are Innovations
Methodology to Ensure Innovation Creates Value
Finding Landmines with Your Eyes Instead of Your Feet: Navigating the Landscape
Emotionally Meaningful Experiences or Memories
Consider All the Possible Users, Stakeholders, and Shareholders
Beneficiaries of Service
Providers of Service
Legal, Compliance, and Security
Provider of Innovative Technology or Service
Framework to Identify Innovation Success Early: 13 Steps for Innovation
Step 1: Problem Discovery
Step 2: Valuate
Step 3: Rapid Low-Fidelity Prototyping
Step 4: Minimum Viable Feature (MVF)
Step 5: Develop a Minimum Viable Product (MVP)
Step 6: Develop Minimum Marketable Product (MMP)
Step 7: Integration Assessment
Step 8: Priority Assessment
Step 9: Product Definition
Step 10: Deploy
Step 11: Scale Operations
Step 12: Drive Efficiencies
Step 13: Incremental Improvement
Chapter 13 Playing with FHIR: The Path to Ensuring We Bring the Power of Supercomputing to How We Understand Healthcare in Medicine
Start at the Beginning
The First Wave: 1974–2003
The Second Wave: Digitizing Clinical Data
The Third Wave: Exchange “Without Special Effort”
What Is Next?
Widespread Easier Health Information Exchange between Institutions
Patient-Initiated Data Calls (aka “Patient-Mediated Exchange”)
Chapter 14 Technology and the Engaged Patient: Evidence-Based Patient Engagement for Improved Patient Outcomes
Chapter 15 Interoperability and Information Blocking: How to Enable Data Sharing and Keep HHS Happy
HIPAA and Sharing
No More Information Blocking for You
Interoperability: The First Step
CMS also includes several resources on its interoperability webpages on FHIR (for the communications), OpenID Connect (as an identity layer), and OAuth 2.0 (as an authentication service), among others
Practices, Behavior, and Cultural Change
Practical Next Steps
Chapter 16 The Role of Standards in the Responsibility and Rewards of Medical Technology Industry Leadership: Identify Your Objectives to Build Your Path in Leading the Future of Medical Technology
Industry Leadership – What Do You Need to Know about Industry Leadership and Why?
Why Software in Medical Technology Needs Standards
How Standards Inform Regulatory Processes
Why Many Stakeholders in the Tech Sector Don’t Know about Standards (Using Food and Other Everyday Analogies)
Highly Regulated Industries
The Value of Convening an Ecosystem
Value of Innovation and Partnering with Entrepreneurs Whether They Are of Tech Companies or a Founder of a Standards Working Group
Case Study of How a Company Successfully Leverages the Confidence of Standards
Appendix A: Glossary of Key Terms