I think our team knows that we have a rock star working with us: Grahame Grieve of Warrandyte, Victoria. He is the principal architect of FHIR and is a contractor for the US Government, Office of the National Coordinator for Health IT. Although Australia doesn’t like tall poppies, Grahame is one. If I’m honest, we value his collaboration in part because of his status. But we mostly value him for his insight. Anyone lucky enough to talk with him about a problem will alter their thinking as he places the problem in the political, economic, and sociotechnical context and then reframes it in terms of what could feasibly help patients.
FHIR underpins the Validitron Sandbox that Kit is developing. In the Validitron team meeting, we compared several potential studies we could do using the Sandbox to improve care models in a virtual ED, including
Does integration of data from a pulse oximeter (or other wearable devices) improve clinician decision making during a virtual ED visit?
How can the waiting time preceding a virtual ED visit be improved for the patient and leveraged to collect information useful for the visit?
Kit and I joined a zoom call with Grahame and other Australian standards champions (one person on the call asked the excellent question of whether interoperability is a product or a process), and there was unanimous agreement that the waiting room study was needed and feasible. The MACH LHS project led by Vicky identified waiting time as one of patients’ most stressful experiences with telehealth, and Grahame asked his friends on Facebook about their experiences and got a barrage of stories of stress during the waiting time.
We also submitted a proposal as partners with CSIRO (David Hansen, Kate Ebrill) and HL7 Australia (Isobel Frean) to the ADHA to develop Australian FHIR training for developers. If it is funded, Kayley and Kit will lead a needs/gap analysis and co-produce a training plan that would include online learning materials, hands-on activities with automated feedback, and activities in the Validitron Sandbox for creating a connected information ecosystem. Grahame asked what type of FHIR training is needed--are the developers the right target? What about clinicians? Everyone agrees we need stories and concrete use cases, and this will be a fun path to take.
I’ve had a hard time getting over this respiratory virus that has been lingering for 3 weeks--I attended, with Meredith and Daniel, a two-day MDHS retreat at Cape Schanck in spite of my coughing and left utterly exhausted. Part of me loved it, and part of me was just drained of energy from excessive socialization. It reminded me that we all have different ways of working and interacting (and draining or gaining energy), and I want to be cognizant of that in the activities we plan.
Regional Linguistic Quirks. I found a phrase that uniquely originated from the US and Australia but not Britain: riding shotgun. From Wikipedia: The expression "riding shotgun" is derived from "shotgun messenger", a colloquial term for "express messenger", when stagecoach travel was popular during the American Wild West and the Colonial period in Australia. The person rode alongside the driver. My kids always yelled out “shotgun” to claim the passenger seat--is it common in Australia as well?
View from my hotel room | My first smoking ceremony | Richard Harris of the famed Tham Luang cave rescue gave an amazing talk |
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