Amputations or Analytics … a Call to Action for Entrepreneurs and Intrapreneurs Alike!

Doctor George Shearer practiced medicine in central Pennsylvania from 1825 to 1878 (in the Dillsburg area). He was a pillar of the community and is believed to have been an active surgeon during the Civil War. He was 61 at the time of the Gettysburg battle.

According to the National Library of Medicine, the exact number is not known, but approximately 60,000 surgeries, about three quarters of all of the operations performed during the Civil War, were amputations. Although seemingly drastic, the operation was intended to prevent deadly complications such as gangrene. There were no anti-biotics during this era.

Back then, amputation was the recommended treatment for major injuries, such as damage from gunshots or cannonballs. These amputations were performed with a handsaw, like the one Doctor Shearer used (shown below). During the war, surgeons prided themselves in the speed at which they could operate, some claiming to be able to remove a leg in under one minute. Ouch! Literally!

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(Photo: Doctor George Shearer’s Actual Surgical Kit)

Keep in mind that local anesthetics were not invented until the 1880s and many procedures were performed without ether or chloroform … the only real anesthetics during the era.

In 1861, this was the best standard of care for those injuries. I think we can reasonably conclude that better treatment options (and outcomes) exist today.

Recently, The Mayo Clinic published an eye-opening report entitled, A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices. The report focuses on a published medical practices and how effective they are. Things must have improved since 1861 … right?

The report examines published articles in prominent medical journals of new and established medical practices (such as a treatment guidelines or therapies), over a recent 10 year period (2001-2010). 2044 medical practice articles were reviewed. The findings are fascinating but one section of the report jumped off the page at me. Of the 363 articles that tested an existing standard of care, 40.2% reversed the original standard of care … and only 38.0% reaffirmed the original standard of care. The rest were inconclusive.

In other words, (in this case study) the current published medical standards of care are wrong MORE then often then they are correct. Wow!

I do feel obligated to point out that this is a very limited slice of the overall published standards of care … but still. It is just me … or is this mind-blowing!

I am not talking about gulping down some Jack Daniels so I don’t feel my leg being sawed off. This is researched and tested medical standards of care within the last 13 years. And yet … over 40% of the time, it’s WRONG. In fairness I should point out that they were right 38% of the time. No wonder the US Healthcare system checks in as the 37th best worldwide despite outspending everyone else by a huge margin (per capita).

It’s 150 years later, has the standard of care improved enough? We may not be sawing legs off at the same rate these days, but maybe it’s time for a new approach. Why are other industries so much farther ahead in leveraging their data with analytics to improve quality, reduce costs and improve outcomes? What could be more important then saving life and limb?

Years of data have been piling up in electronic medical records systems. Genomics is not new anymore. Isn’t it about time we brought analytics to this set of opportunities?

Some leading organizations already are … innovative solutions and companies are popping up to meet this opportunity. Entrepreneurs like Scott Megill, co-founder and CEO of Coriell Life Sciences, is a great example. Coriell Life Sciences is an offshoot of the Coriell Institute for Medical Research, a 60-year-old non-profit research organization. In 2007, the Institute launched an effort to bring genomic information to bear on health management. Coriell Life Sciences was established to commercialize the results of that research. Vast amounts of genetic information about individual patients has been available for a number of years, but it has been difficult to get at and expensive. “This company bridges the gap,” said Dr. Michael Christman, the Institute’s CEO.

Coriell’s approach is so innovative, they recently walked away with the coveted “IBM Entrepreneur of the Year” award.

Intrapreneurs at IBM have been busy commercializing the breakthrough innovation, IBM Watson – that originally debuted on Jeopardy! in 2011. Watson is based on a cognitive computing model.

Grabbing a few less headlines is IBM Patient Similarity Analytics, which uses traditional data driven predictive analysis combined with new similarity algorithms and new visualization techniques to identify personalized patient intervention opportunities (that were not previously possible).

These are a couple of obvious examples for me, but in reality we are just at the beginning of leveraging big data. New analytics and visualization tools must become the “handsaw” of today. We need these tools to be at the root of today’s modern standards of care.   If Dr. Shearer were alive today, you can bet his old surgical kit would be on the shelf, having been replaced by analytics that he could bring to the point of care.

For many Entrepreneurs and Intrapreneurs, the journey is just beginning, but there is a long way to go. A 2011 McKinsey report estimated that the healthcare industry can realize as much as $300 billion in annual value through analytics. Yowza!

What are you waiting for?

As always, leave my your thoughts below.

Best Business Decision Making Tool Ever?

Those of you who know me, know that I have spent my career as both an Entrepreneur and more recently … an Intrapreneur.   I have also been on a slightly quirky quest to find useful tools and models that will enable me to make better, more objective decisions that increase the chance of success and minimize risks.

Whether you call yourself an Intrapreneur or not, you probably have a need to make decisions about your own projects. Which brings me to today’s posting. I have come to rely on a handful of basic but indispensible tools and am curious about whether these are same tools and methods that everyone else relies on.

My favorite tool by far is the SWOT Analysis. I have used it hundreds of times over the years for everything from personal career planning to many different business situational assessments. I even used it to start the project that eventually became IBM’s Patient Care and Insights solution. At the time, we were trying to decide how to approach bringing a major breakthrough in healthcare analytics innovation to market that has been invented by IBM Research named Patient Similarity Analytics … and it all started with a SWOT Analysis.

A SWOT Analysis is an easy to understand and versatile way to assess your position at any point in time. Think of it a tool to assess any situation from 4 different positions or perspectives (Strengths, Weaknesses, Opportunities, Threats).  It can be as simple as making a list for each of the SWOT categories. There are many different ways to apply and use SWOT Analysis. It’s power is in it’s versatility.  Once the items are listed, decision making becomes easier bordering on obvious. The listed items can also be scored or weighted with other relevant information such as likelihood, impact, etc.

Strengths

  • List strength 1
  • List strength 2
  • List strength 3

Weaknesses

  • List weakness 1
  • List weakness 2
  • List weakness 3 
Opportunities

  • List opportunity 1
  • List opportunity 2
  • List opportunity 3
Threats

  • List threat 1
  • List threat 2
  • List threat 3

Catherine Kaputa has a wonderful way to use SWOT as a career / personal brand assessment in her book on personal branding titled “You Are A Brand”

Eisenhower Analysis

Credited to Dwight D. Eisenhower, an Eisenhower Analysis (also known as the Eisenhower Box, or Decision Matrix) is a time management or prioritization tool. It is best used when trying prioritize, organize or otherwise get control of a situation or workload. The goal is to easily recognize the highest priority items from the noise. As an example, many people confuse “urgent” work with “important” work and this helps bring clarity to those kinds of issues. Once the items are listed, prioritizing is clear. Like SWOT, the listed items can also be scored or weighted with other relevant information such as likelihood, impact, etc.

Urgent and Important (1)

  • List urgent important item 1
  • List urgent important item 2
  • List urgent important item 3
Important (2)

  • List important item 1
  • List important item 2
  • List important item 3
Urgent (3)

  • List urgent item 1
  • List urgent item 2
  • List urgent item 3
Neither Urgent nor Important (4)

  • List non-urgent non-important item 1
  • List non-urgent non-important item 2
  • List non-urgent non-important item 3

Franklin Analysis (Pros / Cons)

Credited to Benjamin Franklin, the Franklin Analysis (also known as the pros and cons analysis) is a comparison tool for decision making … typically in a list format. It is used when comparing the pros (positives, pluses or benefits) to the cons (negatives, minuses or costs). This tool is most effective when there are many items to consider and the decision is not obvious. Many people bring emotion into decision making and this approach helps keep an objective perspective. Like the SWOT and Eisenhower approaches, the listed items can also be scored or weighted with other relevant information such as degree of importance, etc.   Totals can even be calculated from the weighted scores.

Pros

  • List positive item 1
  • List positive item 2
  • List positive item 3
  • List positive item 4
  • List positive item 5
Cons

  • List negative item 1
  • List negative item 2
  • List negative item 3
  • List negative item 4
  • List negative item 5

There are literally hundreds of decision making models and approaches but I kept this list to the most well known. What is your favorite tool? As always, leave me your thoughts and ideas here.