Courage

Nov 21, 2018

Yesterday, I spoke at the Wild Health Summit, along with John Halamka, Eyal Oren from Google, and other Australian Health IT leaders.

During my talk, and in regard to how to move forward in regard to Interoperability, healthcare it, the MyHR, and the continued use of faxing in Australian healthcare, I spoke about the need for us to have courage. Today, as a follow up, someone asked me:

“What kind of things should we do to have courage?”

Here’s my top 3 ways that we should act with courage in Australia.

1. Have the courage to speak the truth, and say unpopular things.

Note that this not excuse for being rude, or causing trouble. Nor is it ok to ‘speak the truth’ without first investing time to make sure it’s the truth.  But if it really is the truth, we should say so, even if it’s unpopuler. And there’s a strong view right now in Australia that people need to toe the party line. In regards to healthcare IT, that’s hurting us right now.

An obvious corollary to that is not to punish people for speaking the truth - even if you don’t agree it’s the truth. If they’ve made a good faith effort to find it, then open discussion can follow

2. Have the courage to recognise when you fail, and do something else

To many of us get ‘locked in’ to past choices - it’s a variant of the sunk cost fallacy. Particularly when it’s group activity. How does your department/company/professional society look at projects and decide they’ve turned into a death march? Is the bar to kill a project lower or higher than to create one? Do you have any evidence that you broke the sunk-cost pattern any time?

And don’t think that everything you do will succeed either. If you think it does, then either you’re not trying hard enough, or your analysis is not objective enough. 

3. Have the courage to change how you are accountable to other people

Providing healthcare is a team game, a rich complex eco-system with 1000s of specialties. The real challenge with healthcare interoperability is not getting computers to talk to each other, but getting people to change their behaviour when technology and IT means there’s better ways to do things - different kinds of accountabilities between the players in the team. 

Too often, change is too hard. Even something as simple as using faxes - a constant theme of the day yesterday. There’s no technological reason to use faxes; they’re risky, and costly, but we still are using then extensively - because of human factors. The reaction of our international guests to that discussion (and the MyHR) was revealing: astonishment at the discussion we were having.

Things aren’t going to change unless we have courage. But too many people who listened to me yesterday heard my call to courage as intended for someone else other than them. But you can’t change someone else, only yourself. You, reading this blog, ask yourself:

Do I have courage? Does it show?