McGowan - #socialqi simple solutions for improving your healthcare - PSCG's oaweekprogram Final

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#SocialQI:Simple Solutions for Improving Your Healthcare

Presented by:

Brian S. McGowan, PhD

@briansmcgowanwww.SOCIALQI.com

October 25th 2012

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Outline

1. Redefining Quality2. Why Does Healthcare Quality Suffer3. Introducing SocialQI– One Part – Social Network Science– One Part – Behavioral Science

4. Impacting the Mega-silos of Healthcare: #3 - Biomedical Research Science

5. How Does SocialQI Become the New Norm in Healthcare?

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Redefining Healthcare Quality

October 2012

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My Father’s Health Journey

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My Father’s Record

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Why Does Healthcare Quality Suffer?

October 2012

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Problem #1: Variation

http://www.healthcarereportcard.illinois.gov/maps

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http://www.healthcarereportcard.illinois.gov/maps

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Problem #2: Failure to Advance

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Problem #3: Overload & Filter Failures

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Problem #4: Lack of Information

“Despite recent improvement in timely publication, fewer than half of trials funded by NIH are published in a peer reviewed biomedical journal indexed by Medline within 30 months of trial completion. Moreover, after a median of 51 months after trial completion, a third of trials remained unpublished.”

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Introducing#socialQI

October 2012

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SocialQI

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One Part - Social Network Science

October 2012

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Social Network Science

Six Degrees of SeparationSidewalk Experiment

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http://www.nejm.org/doi/full/10.1056/NEJMsa066082

http://www.nejm.org/doi/full/10.1056/NEJMsa066082

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Unconnected Bucket Brigade Telephone Chain Military Brigades

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1. Collective Intent2. Share Praxis

Moving to ‘Communities of Practice’ models:

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One Part -Behavioral Science

October 2012

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Motivation x Ability x Triggers

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Motivation x Ability x Triggers

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Social Network Science + Behavioral Science = SocialQI

October 2012

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Crowd Accelerated Improvement

http://bit.ly/txvpUP

Light Desire

Crowd

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What does this look like in science?

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Impacting the Mega-silos of Healthcare: #3 - Biomedical Research Science

October 2012

Exploring Chapters 6 and 10

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1. Scientists conduct their research as covert projects, leading to a culture of closed science

2. The system is often manipulated to benefit the scientist and not the science

3. The existing publishing model is an abject failure, driving closed access to medical information and wasting time, energy, and ultimately lives.

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1 - Closed Science

1610:“smaismrmilmrpoetaleumibunenugttauiras”

“Altissimum planetam tergeminum observavi”

“the highest of the planets (Saturn) to be three-formed.”

Nielsen: “Reinventing Discovery”

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1 - Closed Science1997:

“…one in three respondents were denied research results requested from a fellow university scientist in the previous

three years”2002:“nearly half of geneticists stated that at least once in the prior

three years they had been denied access to additional information, data, or materials regarding published research”

2012:“one-third of NIH-funded trials remained unpublished fifty-one

months after completion.”

JAMA 277, no. 15 (1997):1224-1228; JAMA 287, no. 4 (2002):473-480; BMJ 344 (January 3, 2012), doi: 10.1136/bmj.d7292

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2 - Benefitting the scientist, not the science

1. The Multiplier: “Associate yourself with three or four similar academics, preferably at other institutions”

2. The Rapid Data Gatherer: “They get some research output, which helps them, but you get access to their data

3. The Repeater: “Publish the same basic paper in multiple journals”

4. The Avoider: “On no account do anything else”

Mark Smithers, “Playing the Game, Publishing or Perishing inHigher Education,” Learning and Educational Technology in Higher Education(blog), November 14, 2011, accessed September 5, 2012, http://bit.ly/s0GH2y

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3 - Closed Access1. Provide a mechanism to ensure broad reach to new

findings

2. Document priority claim (who discovered what first)

3. Maintain quality thorough peer review

4. Ensure appropriate archival and provide a fixed archival version for future reference

5. Provide an important way for scientists to navigate the increasing volume of published material

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1. Build better models for sharing

2. Integrate new models for reputation and recognition

3. Stop feeding the monster

Finding the Silver Lining

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1- Rise of the Open Access model

Laakso and Björk BMC Medicine 2012, 10:124. http://bit.ly/TN1445

http://bit.ly/TN1445


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1- Rise of the Open Access model




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2 -Birth of Altmetrics

NO ONE CAN READ EVERYTHING. We rely on filters to make sense of the scholarly literature, but the narrow, traditional filters are being swamped. However, the growth of new, online scholarly tools allows us to make new filters; these altmetrics reflect the broad, rapid impact of scholarship in this burgeoning ecosystem. We call for more tools and research based on altmetrics.

http://altmetrics.org/manifesto/


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2 - Birth of Altmetrics• Peer-review has served scholarship well, but is beginning to

show its age. It is slow, encourages conventionality, and fails to hold reviewers accountable.

• Citation counting measures are useful, but not sufficient. …Citation measures are narrow; influential work may remain uncited….they neglect impact outside the academy, and also ignore the context and reasons for citation.

• The Impact Factor, which measures journals’ average citations per article, is often incorrectly used to assess the impact of individual articles. It’s troubling that the exact details of the JIF are a trade secret, and that significant gaming is relatively easy.



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2- Birth of Altmetrics

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3 - Stop feeding the monster• Cost of Knowledge petition:“Timothy Gowers of the University of Cambridge, who won the Fields Medal for his research, . . . asked for a boycott in a blog post on January 21, and [within nine days], on the boycott’s Web site The Cost of Knowledge, nearly 1,900 scientists have signed up, pledging not to publish, referee, or do editorial work for any Elsevier journal.”

• University Policy Revisions:“ . . . non-exclusive right to make available copies of scholarly articles written by its faculty. . . . The University authorizes professors to post copies of their articles on their own web sites or on University web sites, or in other not-for-a-fee venues. . . . The main effect of this new policy is to prevent [faculty] from giving away all their rights when they publish in a journal.”

Fischman, “Elsevier Publishing Boycott Gathers Steam Among Academics,” The Chronicle of Higher Education: Wired Campus (blog), January 30, 2012 http://bit.ly/AvsPlo; Creagh, “Princeton goes open access to stop staff handing all copyright to journals – unless waiver granted,” September 28, 2011 http://bit.ly/qPjfBB

http://bit.ly/AvsPlo

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Finding the Silver Lining

“It no longer seems to be a question whether OA is a viable alternative to the traditional subscription model for scholarly journal publishing; the question is rather when OA publishing will become the mainstream model.”




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How Does SocialQI Become the New Norm in Healthcare?

October 2012

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Patient & Wellness

Communities

Medical Communities

Biomedical Research Communities

What Is vs What Could Be

• Weight Watchers• Alcoholics Anonymous• ‘being a patient’• Isolation

• Quantified Selfers• ACOR• Patients Like Me• #S4PM

• Knowledge is power• Free-agent learners• CME credit gathering• Failed Ed. Design

• #meded, #MDchat• Delta Exchange• OzmosisESP• Rapid Learning Systems

• ‘Dose of Science’• Publish or Perish• Traditional Publishing• Impact Factor

• Mendeley• Sage BioNetworks• Altmetrics• Open Access

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Lesson 1: Rely on better technology

1. Integration: Real sustainable success will only come from our ability to engineer systems that integrate into existing activities

2. Open and Connected: Information flow & big data analytics must

3. Social: Over time knowledge will move from the individuals within the community (knowledge capital) to be shared across the community (social capital)

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Lesson 1: Rely on better technology

4. Incentivizes: ultimately comes down to our ability to tap into the “what's in it for them” of the community

5. Controlled: evolve simple, standard tools to govern the inflow and outflow thresholds

6. Culture: consider ways to scale up culture to enable increasing larger (but productive) communities to form

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Lesson 2: Evolve a new skillset

1. Credibility & Reputation: Increasingly contribution to learning and improvement will define one’s professional reputation within the community

2. Filtering & Search: We can’t just release the bottleneck of information without the new systems to govern the flow…or folks will drowned

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Lesson 2: Evolve a new skillset• Providing Feedback: for true collaboration, getting

along should never be as important as getting things done

• Self-assessment: we must engage the system with our eyes wide open…digital nature allows reflection and social nature allows norming

• Critical thinking & decision making: requires us to know what we know, understand what we don’t know, and not to be paralyzed by the reality that we rarely have all of the information we need

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SummaryProblems

Quality Variation

Failure to Advance

Information Overload/Filter Failure

Lack of Information

SocialQI Solutions

Shared best practices

Peer Norming & Transparency

New systems for simplifying learning

New culture of sharing

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About the book title: #socialQI

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Q and A

October 2012

Health & Medicine

McGowan - #socialqi simple solutions for improving your healthcare - PSCG's oaweekprogram Final