LIQUID NETWORKS ROUNDTABLE

SAMEE/SUSTAINABLE ACTS: MOTHER EARTH’S EMBRACE

PRESENTS A ROUNDTABLE CONVERSATION

LIQUID NETWORKS…YET ANOTHER INTERSECTION FOR THE ARTS AND SCIENCES

SEPTEMBER 17, THURSDAY, NOON – 1:30 PM

UMN Environmental Studies Building           

INSTITUTE ON THE ENVIRONMENT, ROOM #380

1954 Buford Avenue, St Paul Campus

According to Steven Johnson, author of Where Good Ideas Come From, liquid networks connects people and ideas. Based on Johnson’s study as an idea evolves and expands it enters into chance encounters with initially unrelated bits and pieces which collide to produce amazing new perceptions—likened to neural networks. Great ideas, he contends, do not happen in isolation. He found that most breakthroughs, be it scientific or artistic, are not in isolation but at a café, coffee house or weekly meeting where many participate and exchange, re-contextualize ideas while interacting with one another. Together we converse to refine and combine our thoughts and experiments which stimulate ways toward a breakthrough.

SAMEE is the conduit for this exciting program.  SAMEE is an inspirational example of a Liquid Network where the arts and sciences intersect to discover ways to understand and further the sustainability of Mother Earth. In this roundtable conversation, we will attempt a definition of the term Liquid Networks, offer examples, and discuss how Liquid Networks can create community in service for sustainable living and learning.

Faculty:  

Roslye Ultan, UMN/MLS Faculty; SAMEE, Curator: Moderator

Susan Ziel, JD, MPH, BSN, Health Care Consultant/Integrity Health Strategies

Joel Carter, MD, Pain & Palliative Medicine/Park Nicollet Health Services

Teddie Potter, PhD, MS, RN, Clinical Associate Professor UMN School of Nursing

Protected Health Care Communications Using Mobile Devices ... How Does Your Policy Rate?

Do you have a corporate policy that governs your "protected communications" which may be sent or received through the use of mobile devices?  If yes, does your Policy address each of the following "Top 10" requirements?   Here's a checklist to assist you in reviewing, updating (and communicating) your Policy, today! 

1. Key Terms.  The Policy shall define certain key terms, including, but not limited to, Applicable :Requirements (i.e., Federal and State laws governing the privacy and security of protected health and other personal information), Protected Health (and Other Personal) Information (PHI), Protected Communications (i.e., e-mails or texts containing PHI) and Mobile Devices (i.e., laptop, tablet, smart phone).   
2. Policy Prohibition.  The Policy shall begin with an affirmative prohibition  that absolutely no personnel are permitted to use any Mobile Device, regardless of ownership, to send or receive any Protected Communication, whether on or off premises, on or off duty, except in accordance with all requirements set out in the Policy.  The Policy should also state an absolute prohibition of any social media communications or posts that contain PHI.  
3. Authorized Mobile Devices.  The Policy shall state all administrative, physical and technical safeguards necessary for a designated representative (i.e., Security Officer) to authorize a particular Mobile Device, whether owned by the organization or the individual, for use under the Policy.  The Policy should also include (or cross-reference to) an up-to-date log of all Authorized Mobile Devices.  
4. Authorized Software and Applications (Apps).  The Policy shall state all administrative, physical and technical safeguards necessary for a designated representative (i.e. Security Officer) to authorize particular Mobile Device software and applications for use under the Policy. 
5. Authorized Users.  The Policy shall state the requirements necessary for a designated representative (i.e., Chief Executive Officer) to authorize a particular individual, or alternatively, a particular job category, to use Authorized Mobile Devices under the Policy.  The Policy should also include (or cross-reference to) an up-to-date list of all Authorized Users, either by name or job category.  
6. Authorized (and Necessary) Purposes.  The Policy shall specify the particular circumstances when Authorized Users may use Authorized Mobile Devices to send or receive Protected Communications for authorized (and necessary) purposes.     
7. Additional Safeguards.  The Policy shall specify any additional safeguards that are necessary to limit the risk of any unauthorized access to a Mobile Device that continues to store a Protected Communication after the communication has been completed.  
8. Missing Mobile Devices.  The Policy shall require all personnel to immediately report any missing Mobile Device that may store a Protected Communication to a designated representative (i,e,, Security Officer) so to permit a prompt investigation and to mitigate and correct any losses or violations resulting from the incident.  
9. Sanctions.  The Policy shall state all internal and external sanctions that may result from an individual's violation of this Policy, including but not limited to the civil and criminal penalties arising under Applicable Requirements.    
10. Frequently Asked Questions.  The Policy should also attach a series of "frequently asked questions" that are answered concisely with examples, as much as possible.   

If we can assist your organization in updating your Protected Health (and Other Personal) Information Privacy and Security Policies and related forms, please contact us at Integrity Health Strategies for additional information about our cost-effective, fixed-fee service arrangements.   Thank you in advance.  

Susan E. Ziel, Consultant

Integrity Health Strategies

(317) 819-7704

sziel@ihsconsultinggroup.com

www.integrityhealthstrategies.com

Strange Attractors

Meg Wheatley introduced me to "strange attractors" last year when I read her book, Leadership and the New Sciences: Discovering Order in  a Chaotic World.   No, we're not referring to the infamous "do be do" lyrics of Frank Sinatra.  Rather, we're talking about a special force that emerges when a system undergoes transformation.  Here's the skinny.  

• Order exists in every system, even when the system is in absolute disorder and undergoing transformation.     
• You want "quantum" leaders on your team who can find the order within the disorder.  These are the leaders who can see the often invisible shapes, patterns and boundaries -- also known as "strange attractors" -- that will give meaning and hold the system together during these unstable and often turbulent times.
• These "quantum" leaders usually have a well-trained "eagle eye" that can see far and wide.  They are also wise enough to know that absolute disorder is necessary, from time to time, in order to create anything new or better.

Give Wheatley's book a read.  I read it in a single day, while sitting in two different airports, and I was a different person when I reached my destination.   

The "Eagle Eye"

My husband and I recently drove along the Mississippi River in southern Minnesota.  We ended up at the National Eagle Center where we learned all about our country's national emblem, the Bald Eagle.  

Did you know that eagles are known for their excellent eyesight?  Their eyes are almost as large as ours yet their visual acuity is at least four times better than our "perfect" 20/20 vision.  Eagles can see both forward and to the side at the same time. In open country, they can spot small prey over three square miles from a lofty perch. 

For someone who started wearing tiny, pink sparkling "cat eye" glasses at 4 years old, I'm not one to brag about vision but yes, I need my "Eagle Eye" more than ever these days.  For it is those hard questions that often cause me to narrow my focus, to lose both the long (and the side) view, perhaps to even forget that useful "10,000 foot" view that brings the "big picture" back into view.       

Yet again, nature kicks me "in the butt" with its life lessons.   How's your "Eagle Eye?"    

Mind the Gap ... Mind the Monkeys

The London Underground coined the phrase "Mind the Gap" to warn passengers of the risk of stepping into the unsafe gaps between trains and platforms.   Gaps can exist when a train stops at a curved platform.  Gaps can also exist when the height of the train floor and the platform are not the same.  

Beyond train stations, there are many gaps to heed in our daily lives.  In mine, the gaps abound when my "monkey mind" takes over.  

I recall the excellent quote from Elizabeth Gilbert's book, "Eat, Pray, Love" which made me aware of this phenomenon.  It goes something like this ...

"I am burdened with what the Buddhists call the monkey mind.   The thoughts that swing from limb to limb, stopping only to scratch themselves, spit and howl.   My mind swings wildly through time, touching on dozens of ideas a minute, unharnessed and undisciplined."  

Truly, I am what I think.   We all are.  Therefore, we must also mind these gaps ... these monkeys ... and know enough to step away from (or over) them on our journey, before they disrupt our good energy and our path.   

Indeed, here's to safe travels and enjoy the ride!   

Design Thinking

The term "design thinking" is still somewhat new to health care.       

Design thinking is a problem solving process that turns on three principles: (1) empathy, (2) invention and (3) iteration.  

In the case of empathy, design thinking asks us to "mind the gaps" and to put ourselves in the customers' shoes.  In terms of invention, we must act as creators who are all about possibilities.    Finally, iteration means we need to test, fail early and often, and to test again so to learn from our re-iterations (and our failures) along the way.  With a wide-eyed gaze, you question the value of learning from failure, particularly in health care.  For now, I ask that you hold that thought.         

In their book,  Designing for Growth: A Design Thinking Tool Kit for Managers, Jean Liedtka and Tim Oglivie identify four basic questions that drive the design thinking process.  

What Is?  

What If?  

What Wows? 

What Works?  

The question "What Is?" requires us to step away from the crystal ball, ever so briefly, and to collect meaningful information about our current customer (or other) reality.   This is often where we mine data or use observation,  surveys, interviews and focus groups to obtain information.    The use of "a mind mapping" tool is often used to assemble, organize and draw insights from all of the information before moving to the next stage of generating ideas,  which is referred to as "What If?" 

The "What If" stage is all about possibilities.  Here, we want to move from insights to ideas through the use of a brainstorming process that ensures useful output .  The next task is to "cluster" the ideas into one or more robust concepts or hypotheses through the use of a concept development tool.  

The "What Wows?" stage finds the sweet spot where one or more of the concepts or hypotheses at the top of the list are given a "run for their money", both in terms of customer value and profit potential, through the use of an assumption testing tool.   Rapid prototyping, a 3-D modeling process which often resembles a kindergarten arts and craft frenzy, is also used to clarify what a new product might look like or how it would work.  

The "What Works" stage is the time to "get real" and test (and re-test) those prototypes with prospective customers until they are ready for the marketplace as part of a learning launch tool.  Throughout this stage, a willingness to seek input and to fail early (and often) is essential in order to succeed sooner.  

So back to failures, a term that is definitely not new to health care.  Failures -- whether a medication error, a wrong site surgery or a HIPAA breach -- are all unfortunate events to be sure.  But they must also be reckoned with as an essential ingredient to organizational learning.  

In an article entitled "Why Hospitals Don't Learn From Failure," authors Anita Tucker and Amy Edmondson review the many different forces that often inhibit the ability of hospitals (and other health care organizations) to re-frame failure as a meaningful source of learning, not just for managers but also for personnel. 

So, are you curious about this "design thinking" process?  Give Liedka and Ogilvie's book a read.  It is filled with case studies and stories about moving through the four stages of design thinking in pursuit of new and/or improved customer services. If their "fail early (and often)" advice raises your team's collective heart rate, check out the Tucker/Edmondson article which re-purposes failure into feedback.  Feedback that will ultimately take you and your organization to a higher order of problem solving and change over the long run.         

HIPAA Assessments ... Here's Looking at You!

Whether you are the Privacy Officer, the Security Officer, or both, the question remains the same.  

When was the last time you scheduled a "walk through" of your work space for the sole purpose of looking into the "eyeballs" of your personnel and finding out what they are really doing (or not doing) to protect the privacy and security of your customers' health information?  

No, this is not the annual HIPAA security risk assessment.  No, this is not a surprise, mock survey in preparation for some third party visit.   Instead, you are simply showing up and letting your personnel know, first hand, that you really are interested in what they are actually doing to safeguard your customers' protected health information  "PHI."   Nothing more.  

In working with our HIPAA clients, we always recommend an annual HIPAA assessment calendar that sets out a series of compliance "questions" that will be reviewed -- one for each of the 12 months -- as part of an ongoing assessment process.  The calendar can always be updated (or supplemented) as new questions or issues arise through the year.    

For example, if this is January, then you may be in the HR department with the education coordinator reviewing a sample of personnel files to confirm that documentation exists to confirm completion of all annual HIPAA training.  In April, you may join a supervisor and walk through their department work space at the end of the business day to look for any printed copies of PHI that may have been left on a counter or on a fax machine, all for easy "view" by the after-hours cleaning staff, or otherwise.  .    

In June, you may make rounds with the medical records staff to query them about how they work through their checklist for subpoenas and other third party requests for records.  In August, you may meet with the CFO's contract manager to review a sample of vendor agreements that should include a fully executed Business Associate Agreement.  In November, you may seat yourself in a public waiting area with one of the admissions staff and listen for any "incidental" disclosures that could be overheard by other customers and their family members who are seated nearby.  

In August, you may request a current copy of your organization's "workstation" inventory  and confirm whether its up-to-date by conducting an assessment of all computing devices - whether owned by the organization or workforce, including desktops, laptops, tablets, smartphones and "any other devices that perform similar functions" and which are used on (or off) premises.   According a May 2018 OCR Cyber Security Newsletter (link is https://www.hhs.gov/sites/default/files/cybersecurity-newsletter-may-2018-workstation-security.pdf), the physical security of all such "workstations" requires a complete inventory and ongoing training programs that communicate the reasonable safeguards necessary to protect these "workstations" -  such as encryption, strong passwords, secure use in public areas, secure storage when not in use, and and up-to-date policies that are communicated in both orientation and annual training programs. 

Of course, HIPAA assessment worksheets can be used to score and report your observations to create a paper trail and keep your leadership apprised, but it is the "eyeball" connection with your workforce that is truly the bottom line here.    

Raise the bar, raise the awareness and show up.  It only takes an hour once a month to get this done.  Here's looking at you -- in your hallways and departments -- very soon!