Big Ideas that Matter in the World and in One’s Life

Z&M–This is yet another article  that causes me to suggest that you read ‘ip’ regularly.

There are so many great and important ideas in the article, I hardly know where to start. So, if my experience tells me that’s its a  few "big
ideas" that matter more than most choices in life–you won’t find me touting career paths in computer science, medicine, law,
business, physics or math–you’ll have to bear with me as I point to the ideas below and in posts yet to come, some others.

I’ve highlighted the relevant text but you should read the whole
yourself–even the longer paper referred to by it–rather than rely on
my restatements here. Stephenson’s ideas apply not just to
government, but to every sphere of life, even to oneself.

"My argument is that government can transform itself both internally and externally, improving performance, lowering costs, and building public support and involvement, through a combination of:

* automated (preferably, real-time) data feeds, at first behind the firewall, and then externally as well, in a variety of formats such as RSS and KML

* easy access for both employees and (again, eventually) the public, to the growing number of easy-to-use Web 2.0 data visualization tools that allow taking data that may be hard to understand in tabular form and instead turn it into eye-catching and informative visualizations — plus Web 2.0 tools such as tags, topic hubs, and threaded discussions that encourage sharing the data and insights — and increase the chance of ‘wisdom of crowds’ knowledge emerging as a result!"

Get the data out there where you (and those few others
with whom you work most closely) can see it by the cold light of day. It means
you have to get out of your head and onto paper (I still think it’s better) or
screen. First approximations or rough cuts are marvelously useful, perfection
is not needed at the start—probably never. 

Announce yourself what the data shows—even when
diametrically opposed to what you’ve been saying. Reinventing oneself is the
key to survival, growth, opportunity and ultimately stability and contentment .
. . one becomes content with the process of change, not the state one is
presently in—as we know from physics it is easy to be fooled by a meta-stable

Communicate your data to all. Go public–it may not be
the global community or even your neighborhood; perhaps just other groups at work. Do so in a way that people can grasp intuitively—or with
minimal explanation. If the office assistant, janitor or supply room stocking
clerk doesn’t understand it—it’s too dense; get away from the tables and move
to simple graphs. Tufte shows the way with his simple design beauty.

I’m not so sure about the "wisdom of crowds", but a group convened for the purpose is surely smarter and more effective, when well led, than the genius working alone.

Is it time to drag private physicians out of the paper age?

Published: June 24, 2008 
If this country does not accelerate the conversion from paper to electronic health records, many health care reform promises will become irrelevant. 
Yes. So? 
American physicians are still paid on piece-work; productivity matters to them and their families. Seeing patients pays the mortgage and feeds the family. 
I’ve successfully implemented an electronic medical record that has served more than one-half million patients since 2002, yet I know that we’ve accomplished this only by sacrificing physician productivity even as we’ve improved overall productivity in our emergency department. Optimizing an entire system often requires that components of the system operate at less than optimum in some fashion. 
We can do this at my hospital because our physician staff is only partially compensated by piece-work and the alternative subsidies could be adjusted. 
The NY Times got it wrong this time. Private physicians behave as they do in response to the totally distorted payment system–even the term "reimbursement" so common in this context is evidence of this distortion. 
My Dad, an internist, used to say that the head-bone is connected to the foot-bone. He practiced internal medicine and gastroenterology and empirically experienced connectedness of the head-bone and the gut long before we had the science proving it. 
It’s not the private physicians who must be dragged out of the paper age. It’s the payment system and the financing of healthcare in 21st century America. 
The NY Times should castigate our policymakers, not our practitioners.