The Nature of Information Has Changed, and so Should Our Approach

Posted on May 7, 2014 | Leave a comment

If you are at least 25 years old, you would remember the days when everyone is trying to expedite the speed of information transfer.  Messages began with the courier services, first by horse, then by car.  Then they went digital.  The internet began with dial-up, when 56kbps was deemed state of the art, then broadband.  Then we decided that having to sit in front of a computer to transmit data is too slow.

Back then, when you get a wrong piece of information, it was usually because of timeliness.  Timely data was the business of newspapers, radios, and later television.

At some point, the speed of data transmission became near-instantaneous.

We had thought that faster information means better, but it may come at a cost.  Rapid information is raw, and sometimes inaccurate.  This is a common occurrence, but like car crashes relative to plane crashes, what made Twitter newsworthy is the few times when it nailed the right information seconds after an event, not the hundreds of thousands of times when it misfires.

Like breathing air, bad information has become so commonplace in Twitter and blogs that inaccuracy is invisible to us – we easily process the concept and underlying logic behind why rapid information is sometimes inaccurate, we just don’t think about it often.

And yes, I am aware of the hypocritical nature of using a blog post to divulge this argument.  As it turns out, the burden of verification is on you; I’m just exercising my first amendment rights. 🙂

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Posted in Technology and Informatics

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Memorable events

Posted on May 5, 2014 | Leave a comment

We’d like to think of ourselves as the sum of our prior experiences, learning and growing over time. As it turns out, we do not accurately remember our experiences. What we identify as our own “experiences” are not experiences at all but memories. What end up as memories tend to be the outliers of those experiences.

In the words of Nassim Nicholas Taleb, these are black swan events.  But black swan events do not just apply to large organizations or countries; they also occur in our everyday lives.  Our experiences compete for space in our limited memories, and we remember the black swans.  Since the events we forget do not simply reside in memory as gaping black holes – like the retinal blindspot, the brain simply does not perceive the forgotten events, it may then be suggested that black swan experiences shape who we are.

Thus, it follows that to live a fulfilling life, one should optimize on the quality and number of memory-worthy experiences.  It means to take frequent vacations, see new places, but it also means to attempt a wide array of extra-curricular activities, learn a few things about areas outside of our expertise.  It means surprising our lived ones with something special spontaneously so they too can share some of these memories with us.

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Posted in Figure Stuff Out

[Quote] “Science has eliminated…

Posted on May 4, 2014 | Leave a comment

“Science has eliminated distance,” Melquíades proclaimed.  “In a short time, man will be able to see what is happening in any place in the world without leaving his own house.”

 

– Gabriel García Márquez, One Hundred Years of Solitude (1967).

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If not for distractions, for the people

Posted on May 3, 2014 | Leave a comment

When I’m alone, it’s very easy to slack off – watch YouTube videos, read a novel, Twitter, Facebook. Working in the presence of another person or people is an entirely different story.

I had thought that working in a coffee shop helped me focus because it had less distractions, but as technology advanced, my sources of distraction also mobilized and followed me through smartphones, tablets, and always-on connectivity.

If not for decreased distractions, perhaps I go to these places for the people. There is something special about being in the presence of someone else. That someone can be a significant other, a good friend, or even a stranger. It’s as if we have some accountability to the other human beings in the same room regardless, even to the stranger minding his/her own business at a different table, to maintain that self narrative of “I’m supposed to be productive.  Let’s get to work.”

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The Irony of Consolidating Innovation

Posted on April 29, 2014 | Leave a comment

Innovation competition is a common mechanism for developing novel products or or otherwise encouraging creative people to do what they do best – create.  Entire organizations are formed around innovation (IDEO being a high-profile example).

The logic that high rewards attract high performers is reasonable.  And consolidating resources to fund two critically acclaimed novel inventions arguably makes more sense than dividing up the limited funds among 20+ ideas with variable viability.

But these assumptions only work if one makes the assumption that the inception of an idea is a planned process with an “innovative index” directly proportional to effort.  Only then can one make the conclusion that bigger rewards draws better ideas – it does so because people try harder.

But what if creativity is not an effort-dependent activity?  What if innovation, like chemical reactions in equilibrium, only appears predictable on the macroscopic level but is in fact sporadic and dependent on some lucky combination of kinetic creative energy colliding against one another?

It then comes as no surprise that many NIH-funded projects are sustaining innovations, those creating incremental improvements to existing technology.  2% improvement in blood pressure control.  Statistically significant but clinically undetectable improvements in cholesterol control.   Seven Tesla MRIs.  Sustaining innovations, by definition, build on a solid precedence and have higher probability of showing positive results, albeit by a smaller magnitudes.

Disruptive innovations are the smartphones, the PCR machine, the first AML chemotherapy.  They wield the ability to change entire industries; they are also rare.  They are one-in-a-million chemical reactions that require collision at a precise angle with the right kinetic energy.  One might even say that at the start, the inception of a disruptive innovations is sporadic, a lucky accident.

If earth-shaking novel ideas occur by chemical reaction, then it may be clear what we as a society must do to foster them.  The chemist does not give her molecules incentives and rewards for making a carbon-carbon bond.  Instead, the chemist selects the ideal solvent to make the reaction possible, offers a catalyst to lower the activation energy, and gently heats the primordial soup of innovation.

Then she waits, for above all, innovation takes time.  Innovation can’t be made to happen; it can only be allowed to happen.

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Posted in Radiology Innovation and Quality, Technology and Informatics

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The hardest thing I’m learning

Posted on April 28, 2014 | Leave a comment

The hardest thing a novice radiology learns is where to see the critical finding leading to the right diagnosis.

The second hardest thing a novice radiologist learns is how to ignore the noise.

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Posted in Figure Stuff Out, Radiology Innovation and Quality

The Quest for Working Happily Ever After

Posted on April 18, 2014 | Leave a comment

Heart rate mildly elevated, the sweat glands open, eyes fixated on the task at hand.   Time feels slow – or even frozen – but also at once flies by between each glance of the watch.  It’s an experience termed flow, which has been famously described by Mihalyi Csikszentmihalyi in a book by its namesake.

Flow has many components, but the most easily understood set include challenge and feedback – engaging in a task just sufficiently difficult to the level of ability and knowing immediately whether you did the right thing.

Like Fight Club, the experience was in everyone’s face; Csikszentmihalyi just made it visible.  The experience was on everyone’s tongue, and he just gave it a name.  In fact, it’s an experience so addictive (yes, flow experience and cocaine both use the dopamine pathway) that we sometimes spend the entire first half of our lives seeking that experience which we call a career. Continue reading →

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Posted in Figure Stuff Out, Radiology Innovation and Quality

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Closing the loop of communication

Posted on April 9, 2014 | Leave a comment

One of the best advices a mentor gave me during school was to close communication loops as quickly as I can.  In a world when constant information flow can occur on cell phones and a variety of social media, even a one-day wait for an email reply can seem archaic.

This idea is not new, though.  A basic recommendation written in Getting Things Done by David Allen is triaging your email inbox – if you can answer an email in two minutes or less, then go ahead and do it; if not, leave in your inbox.  He also recommends cleaning out your inbox daily (using the Archive feature in Gmail, for example).

The need to close the communication loop is formally required in many organizations such as the military and in medicine.  For example, critical medical findings on x-ray cannot just be communicated to the doctor or nurse; they must be accompanied by an acknowledgment, which typically involves a read-back.

In online communication by email, texting, or social media, there are three major categories of responses in practice: (1) reply to resolve the request, (2) contacting someone else to gather information before resolving the request, or (3) diverting the request to someone else who will resolve it.

What is sometimes forgotten is that we own the communication even after we did the right thing by gathering additional information or forwarding the original email to someone else – categories (2) or (3).  In other words, the original sender is unaware of the actions taken and is still waiting for our reply.  In the end, an additional 10 seconds of our time taken to close the loop with the original sender by a quick “I will forward this email to the John” (or by simply cc’ing the sender in our actions) can significantly increase our rapport with them.

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Information is only as good as its means of delivery.

Posted on March 17, 2014 | Leave a comment

Life is a series of decisions often made using imperfect information.

There are two ways to end up with imperfect information. First is that the information source is itself incomplete: nothing in medicine is 100%, the stock market is inherently unpredictable, as is weather, and we even can’t be sure that the organic pears aren’t grown using pesticides.

Outcome is only as good as the best information affords.

Even given a perfect source, imperfect communication of information also leads to flawed information.  Loss of emotional cues when transitioning from face-to-face to telephone to email to instant messages.  The dreaded typo “Oh that sentence was supposed to have a ‘not’ in the middle of it.”  Even the world as we see it is limited by our eyes – myopia, glaucoma, or perhaps simply the visible light spectrum.

While it is difficult to improve the quality of information source, using the appropriate means of communication to properly deliver information is sometimes easier.  It might just mean a strategically placed emoticon ;), careful proofreading, or a pair of glasses.

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It’s always more complicated – but so what?

Posted on March 6, 2014 | Leave a comment

As a college student I thought medicine is just a vast combination of facts, then medical school taught me that it was more complicated.

In medical school I thought that radiology is just about pattern recognition, then residency taught me that it was more complicated.

In residency I thought that the health care crisis is just a problem of not enough money, then business school taught me that it was more complicated.

In business school I thought that informatics is just about customizing to user needs, then working on a project taught me that it was more complicated.

But after being wrong so many times, I find myself continue to simplify complex concepts in my head. Maybe we’re built to do that. If I knew how complex medicine is, I may have gone into another field.  If I knew how difficult radiology is, I may have applied into another specialty.  If I knew the full complexity of healthcare informatics, I may have waited years before launching into a project.

Maybe it’s how society moves forward – by foolhardy people acting on oversimplified versions of the world.  Although the person who jumped in without understanding the complexity of the world might frequently fail, the person who held back would always fail no matter how much complexity he appreciates.

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Posted in Figure Stuff Out