GTD and The Invention of the Medical Record

In my work with Mayo Clinic in news media relations, I always look for applications of the principles of Mayo’s medical practice. Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. I figure the same principles that make Mayo Clinic successful as a medical practice would be likely to lead to success in relations with news media, too…and in my personal life. Or at least they would be a good place to start.

One of Mayo Clinic’s innovations, just over 100 years ago, was the unified patient record. In that day it was revolutionary to even think of physicians working in teams instead of taking individual responsibility for their patients. But Dr. William Mayo and Dr. Charles Mayo knew what they didn’t know, and that knowledge in medicine was growing so rapidly that they needed to combine the expertise of others to get the best results for their patients. As Dr. Will put it, “…In order that the sick may have the benefit of advancing knowledge, union of forces is necessary.”

The Mayo brothers saw that to have that “union of forces” it also was necessary to have a centralized medical record for each patient, instead of each physician keeping notes in a journal. One of the early Mayo partners, Dr. Henry Plummer, developed this pioneering system that is taken for granted today. It wasn’t obvious at the time.

Now Mayo Clinic has a completely electronic version of the medical record, which enables specialists to collaborate even more efficiently, because they can be looking at the same patient’s records and images, even if they aren’t together in the same office…or even in the same state.

How does this relate to GTD and “stress-free productivity?” David Allen says an external, trusted system is essential. You can’t keep it all in your head. You need to put your information into a system that you know you will review regularly, and from which you will be able to get the information when you need it. With that, you can be “in the moment” and focus on what you’re doing right then, instead of thinking about what you’re not doing.

Mayo Clinic is able to efficiently diagnose and treat more than 500,000 patients a year because its systems are organized so every piece of information needed is available at the point of care delivery, and because processes are set up to get data into the system quickly, easily and completely. Caregivers know and trust that all of the information is in the system. That, and the salaried model for compensation, enables physicians to take as much time as they need with each patient, without feeling stressed and hurried.

So how have we applied this to our media relations work? Our media relations team has developed a similar system for press calls, so when a journalist calls for a comment from one of Mayo’s medical or scientific subject experts, or in response to a news release, we can track what happened with that call. It’s a trusted system, because every call we receive is entered into it.

That’s probably why GTD resonated with me so much, and why I just took the plunge after reading the book on my plane ride home from Jacksonville.

Taking the time to organize a system really fits with Mayo Clinic’s heritage, too. When Dr. Plummer invented the centralized medical record in early 1907, he just disappeared for a few days to do it. When he came back, he had invented the basic structure that is still used today, nearly 100 years later. I suppose he could have just said he was too busy with the press of patients to see, that he couldn’t make time to get away and do this planning. But patients all over the world are better off because he made the time.

Your investment of time in establishing your GTD system probably won’t have such an enormous payoff for all of humanity as Dr. Plummer’s did. But who knows? Maybe it will.

It will make a long-term difference for you personally. By developing a system that lets you make your decisions up front about where different kinds of information should go, you will save a huge amount of time in your everyday life. You won’t find yourself caught in dilemmas, wasting time trying to decide where a given bit of information belongs. You will have some rules and structure that reduce these collecting and processing decisions to a snap, because you’ll know where things should go.

It is practically necessary to have both paper records and electronic systems for organizing your life. Paper isn’t going away, and virtually everyone today also needs a system for tracking the electronic inputs, too…e-mail, at a minimum. In a future post I will look at systems for both physical and virtual organization.

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GTD Roadmap: Meeting Morpheus

The Matrix

One of the high points of my last year with GTD was attending the DavidCo Roadmap Seminar in Minneapolis on May 5. I had taken the red pill by just plunging into the GTD system, reading the book and trying to apply it consistently. The book alone is more than adequate to help you make great personal productivity progress, even imperfectly applied. Like Neo in The Matrix, I started to see new ways of doing things, and how to defeat the Agent Smith of procrastination.

Attending the Roadmap would be another great way to start, or to re-energize your application of GTD. Hearing David Allen in person is like meeting Morpheus.

In The Matrix, Neo learned jujitsu and Kung Fu in 10 hours. A day with David at the Roadmap seminar won’t make you a Black Belt in GTD, but it’s still a worthwhile investment.

You can read more about my experience with GTD in the last 51 weeks here. Also, check out the Black Belt Productivity blog. I just discovered it while composing this post. It’s going in the list of feeds I read.

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Electronic Disruption Not Just for Media

Whatever you think of global warming as a scientific phenomenon, from the perspective of John Kotter’s penguin fable it is undeniable that economic icebergs are melting from underneath all sorts of businesses and their employees.

Time magazine announced some huge changes this week, and Jeff Jarvis, as usual, has a spot-on commentary. I found this statement particularly compelling:

I think that general-interest magazines may well be fated to fade away. General-interest anything is probably cursed. For the truth is that interest never was as general editors and publishers thought it was, back in the mass-media age. Old media just assumed we were interested in what they told us to be interested in. But we weren’t. We’re proving that with every new choice the internet enables.

Yet special-interest magazines — community magazines, to put it another way — have a brighter prospect — if they understand how to enable that community.

Time‘s travails, the ouster of the LA Times‘ editor for refusing to adapt to economic realities, the continued decline of newspaper readership, and Gannett’s more realistic approach to the kinds of changes needed for long-term success in the news business highlight the pace and extent of change we all face.

Large, established news media organizations probably feel this most acutely, because they have seen their core business as creating, editing and distributing content to mass audiences. Too often they also have tacked “on paper” to the end of that sentence (or some other specific medium that reflects the way they have always done it.) As technology drives the costs of developing and distributing content toward zero and choices multiply, the erosion of mindshare for the old-media oligopoly is inevitable.

But although those working in media may feel the changes most acutely (or at least have a bigger megaphone, even in a fragmented media landscape, to talk about it), icebergs are melting in all sorts of industries.

The New York Stock Exchange announced this week that it would cut employment by 17 percent, or 500 jobs, largely through and because of more electronic trading.

Amazon’s S3 service (I need to look into this) offers unlimited data storage and transfer at low flat rates, enabling start-ups or more established companies to focus on building their business and traffic, instead of how to scale their server space. Don MacAskill, CEO of SmugMug, details how S3 has saved his company well over $500,000 in the last seven months, and how he expects savings of well over $1M in 2007. He was spending that money somewhere else before he made the change to S3, so for whoever those vendors were, some warm water is coming under their iceberg.

Congratulations to those organizations that are keeping their eye on meeting needs and serving customers, and finding ways to meaningfully contribute. Not all will be successful. But it’s great to see organizations like CBS sending out “scout penguins” by launching a service like this, to see if this is a way to provide information people want.

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Thoughts from the Bulldog Online Measurement Teleconference

In the Bulldog teleconference today I came away with some helpful insights about how to use online monitoring. My earlier post has more of the points I made.

Evan made a really good point that you need to measure things that are in keeping with your goal, and what the desired user response is. For example, if your goal is to influence opinion through an initiative as opposed to selling something, focusing on click-throughs is short-sighted; it gives you numbers that are relatively meaningless.

Angie Jeffrey walked us through a measurement matrix she has developed. You can reach her for a copy of this by email at (I think she will be willing to share this if you ask. Please let her know Lee sent you her way…which would be one way of getting some anecdotal measurement of how many people are taking action based on this post.)

Donna added that setting measurable objectives means we need to define the target audience, what we want them to do, and in what time frame. For example, we want 75 percent of articles in electronics trade publications that mention our company to include at least half of our key brand messages. She also showed her dashboard of key measures, which she uses to share information with TI management.

I would welcome any comments or questions from people who want to have a discussion about this.

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