Consumer Engagement & Meaningful Use

Below is the comment I posted on the Creating a Vision for Engaging Patients and Families Through the Meaningful Use of Health IT post on the Federal Advisory Committee Blog (as of this post, comment still in moderation).

Thanks to the HIT Policy Committee Implementation Workgroup for hosting an interesting, informative, and lively hearing on consumer engagement today!

It seems there is a fair amount of consensus and support for the current suggested meaningful use criteria for the coming few years. These requirements should serve as a floor – not a ceiling – for progress towards achieving a stronger technology-based health care system. Assuming I am understanding Dr. Tang’s carrot vs. leash analogy, we have a carrot-based framework outlined for encouraging providers to move in the right direction between now and 2015.

However, a possible unintended consequence of having relatively simple and broadly achievable meaningful use requirements is that the articulated criteria may have the effect of stifling innovation among the next generation of health care solutions providers. I suggest we consider creating a second ‘track’ for meaningful use.

Just as a gifted child will likely become bored and disengaged with remedial classroom instruction, current meaningful use criteria will do little to inspire forward thinking health care providers and ‘health 2.0’ innovators. I wonder if it is possible to create an experimental advanced track for the more nimble and tech-savvy crowd of solution providers. This would be equivalent to ‘severing the leash’ for the more advanced folks. Whatever innovation, promising solutions, and lessons learned come out of a ‘meaningful use sandbox’ could be shared regionally and nationally…and inform future policy.

If you have any policy-related comments, please share them on the Creating a Vision for Engaging Patients and Families Through the Meaningful Use of Health IT post.

Interrupt Me Not

I take pride in being a pretty nice person. I am generally very accomodating and I am always an excellent listener. I turned mean, though, on a recent evening. I was talking to a couple of men I know and was sharing an observation about social influences in culture when - mid-sentence - one of the men interrupted me to tell me that my shirt was pretty. If I wasn't so into peace and non-violence, I think I would have enjoyed slapping him right about then. Instead, I gave him a really, really mean look.

He immediately went on the defensive (or more like offensive) and tried to make me out to be an ice queen who couldn't take a compliment.

His friend - let's call him Switzerland - tried to keep the peace. I told Switzerland that this wasn't about this particular incident; it was about a pattern of behavior. Mr. Pretty Shirt oscillates between teasing me and chiding me for being so quiet. That's why it makes zero sense that when I finally start talking, he makes a habit of interrupting me.

Mr. Pretty Shirt is a good person at heart, but is unaware of his tendency to dominate conversations. I think no one has really called him out on it because he's a man. I guess he has enough redeeming qualities where people are willing to put up with this behavior (myself included, thus far). I've seen people deal with him by being loud and boisterous and interrupting back, but that just isn't my style.

Why do we (usually women) put up with this behavior (usually from men)? Well, look at Mr. Pretty Shirt's reaction: instead of acknowledging that he offended me, he acted like I did something wrong. Whether men realize it or not, the deck is stacked in their favor when it comes to defining social situations. There is plenty (I'd estimate a boat load) of research to document this. It has to do with a lot of things ranging from hormones to social upbringing to linguistics.

Why am I writing about this? First, I love writing about taboo subjects that few people want to touch. Second, I think men could use some honest feedback (and it's probably easier to digest the information through a story about someone else's misstep).

P.S. Obviously not all men are like this. In fact, most of the men with whom I interact are quite the opposite. Also, I have a couple of close female friends (you know who you are) who are infamous interruptors. What I am talking about is a pattern and how it plays out when men and women interact.

P.P.S. I've been watching how these dynamics play out in social media for more than a year now. Really interesting stuff. There are definite gender dynamics that play out explicitly and implicitly, both online and offline.