Saturday, September 06, 2008

Sleep on It

Yesterday, I had to install a security update on my work PC that required a reboot. I dutifully closed the 20 or so windows of stuff I had open, making sure I had saved each document. Later that day, I went to open a draft of a whitepaper on the use of electronic data sources for drug safety surveillance as a follow-on to BearingPoint's work on the eHealth Initiative Connecting Communities for Drug Safety Toolkit.

No document. No trace. Nada.

I can't recall the last time I've totally lost a document or file. I backup my hard drive, archive email and am pretty religious about hitting the save button (seems my spiritual calling has been downgraded from saving souls to saving documents, but that's another story). But the biggest change that's happened, frankly, is that Microsoft has gotten pretty good at making sure documents don't get lost when their applications crash. They crash pretty often still, but at least when they do, you can almost always pick up the pieces.

I had already put in several hours over three days into editing this paper and was probably less than an hour from finishing. With extreme diligence, I look through every option I could think of to find it. Hidden file searches, Google Desktop, looking to see if I had named it something else accidentally in the process of saving it. In the end, I figured that I had been saving the temporary internet file of the draft that had been sent to me via email. But when I opened it again from the email, another instance of the document - Whitepaper(2).doc - came up containing none of my changes.

The path address for that file was in the Temporary Internet File folder a couple of subfolders down. But when I looked in the TIF folder, there were no subfolders showing - even though I had made sure that all "hidden" files would show.

I gave up, resigned to the idea that I would spend a good part of the weekend rebuilding what I had already done.

My favorite time of the day is that place between when I wake up and when I get up. Things become clearer during that intersticial space between dreams and reality. It's when I'm best at figuring out puzzles whose solutions have eluded me - be they that one last line in the lyric of a song, a business issue or trying to remember where I left my sunglasses.

Today when I returned to my computer, I typed the file path into my Windows Explorer browser and the hidden files appeared one by one. There among the hundreds of temporary files was a beautiful sight - my lost file.

The weekend is saved - or at least it gave me enough time to treat myself to a little blogging...

Thursday, September 04, 2008

NCPDP Modeling & Methodology Road Map

Yesterday, I sent this email to a bunch of folks working on creating a new road map for developing pharmacy and ePrescribing-related standards through NCPDP, the National Council for Prescription Drug Programs, a standards development organization. Too often, volunteers like these never get the credit or thanks they deserve for working on something so esoteric and abstract, but that is, nevertheless, absolutely critical in my view to transforming the current healthcare system into something that actually resembles a system. If you're one of those people working on similar thankless initiatives, thanks to you too... and please, please keep up the good work.

To the members of the NCPDP Modeling and Methodology Road Map Task Group –

I got a lump in my throat reading this document today. That’s a good thing.
It took me back to 2005 and the many conversations Jim McCain and I had about how important data modeling will be to the future of NCPDP and our ability to create standards that are more readily interoperable with other healthcare information exchange standards. There wasn’t much of an appetite for these ideas back then – mostly because people didn’t know what the heck we were talking about. But the leaders of NCPDP also understood that we were in danger of building standards that, while effective in meeting current needs, could someday become a “bridge to nowhere” if we didn’t look at how they could be more aligned with standards used in other environments. So the group received the Board’s blessing and got up and running.

I wish I could have been more involved in this most recent work, but from what I’ve just read, you did more than fine without me. Point by point, you’ve articulated a set of rock-solid arguments for why we need to move toward model-based standards and have developed a clear road map for accomplishing that goal. I’m truly in awe of the quality of this document’s contents and how well they articulate a detailed approach to achieving what was an inexact if not impassioned notion three years ago.

What we have now is a way and a plan; what we still require is a means and the will to execute on this plan. NCPDP will be more effective in creating future standards by adopting a model-based approach using open-source tools. But our success in achieving the ultimate goal of creating semantic interoperability within healthcare will be severely limited unless we get the rest of the healthcare standards development community to follow a shared path. That’s why I believe that it’s extremely important that we quickly vet this work and share it with other SDOs – perhaps through our ongoing SDO summit meetings.

Workgroup 15 – Sample Management and Activity Reporting Transactions for Safety – will be starting work on developing draft standards for drug sample data so samples can be managed through electronic prescribing systems and included in medication histories. It’s a fairly small and simple domain relative to others and it may be a good environment in which to work through the soup-to-nuts modeling process so that we can further refine it. We would need a modeler to join our task group, but would welcome the opportunity to demonstrate this capability.

If I go on much further, they’ll have to cue the orchestra to begin playing “America the Beautiful”, so I’ll just offer one more thought: The main reason I felt so compelled to blather on about your work is because I’ve experienced the gratitude of a patient whose life was saved or made better because of something I did back when I was involved in direct patient care. Sadly, people won’t be coming up to you in the street to give you hugs because of how you changed their lives. That’s too bad because this work will ultimately impact more people than any individual doctor, nurse or pharmacist ever could. I just wanted to let you know that someone sees it, understands its relevance, and wants to thank you deeply.

Thank you, thank you.