In the late 1990′s I was involved with a group called Vvaleo formed by Dee Hock (founder of Visa International and proponent of “Chaordic” organizations) Rob Kolodner (then of the VA), David Cooperrider (CASE, founder of Appreciative Inquiry), Tom Garthwaite (head of VA health care), Heather Wood Ion (then CEO of Visiting Nurses Association of Orange County), Don Lindberg (National Library of Medicine) and others.
Heather Wood Ion and I were seeking to apply Jonas Salk’s ideas about creating an Epidemic of Health (this was the last paper he edited before he died.) Reframing health care to the positive – creating a viral expansion of positive, health-inducing and supporting ideas, activities, technologies, and support structures is a fundamentally different framework than seeking out what’s wrong and how to fix it. This was my first exposure to David Cooperrider’s notion of Appreciative Inquiry (Thanks David), and it really rang true to my thinking about what I called “benegnosis” (a way of understanding by what is positive) in contrast to “malgnosis” (a way of understanding by what is failing). The Vvaleo group had a few interesting meetings and support from the VA as well as the Fetzer Institute. David also invited me to the Images and Voices of Hope meeting at Peace Village in Haines Falls, NY.
We developed an Appreciative Inquiry Living Dialog to Support Health Care to support the ideas. The idea petered out in time (a story in itself – coming soon). But I think it is a good framework upon which to rethink health care reform ideas, and to lift our thinking above the “disease industrial complex” which is so prevalent in today’s climate. I think that this also has a lot of relationship to the National Health Information Network, an effort now headed by Valeo founder Rob Kolodner. After 30 years of tilting windmills with Rob in the VA VistA (then DHCP), then Vvaleo, and now the National Health Information Network, I think he is in a unique position to understand the role of Information technology and how it can lead, rather than follow, organizational reform.
Suddenly the Veteran’s Administration’s VistA program is a hot topic. As one of the original designers of the system, it is a rare opportunity to look back and see the evolution of an idea over three decades. The system has expanded to process about 12% of the hospital information system computing in the US, throughout the VA, DoD, and Indian Health Service.
I was recruited into the VA in 1978 by Marty Johnson. Henry Heffernan was also active in the background. I wouldn’t say it was kicking and screaming, but I was certainly reluctant. I was quite excited about microcomputers, having grand visions of starting the “Friendly Computer Company.” I had written a book called the Friendly Computer, which got published in Germany as Der Freundliche Komputer. Microcomputers, not minicomputers, were my major interest.
And, seeing Phil Longman write a book called The Best Care Anywhere certainly makes all the effort worthwhile. Sitting in a cramped office at the end of the Psych ward in Loma Linda, I had no idea that my grandiose vision would flourish the way it did. I remember it as an intense time of furious innovation, collaborating with people all over the country to try to get a system up and running before the evil centralists shut us down. And I do mean “evil.” I was stuck using a 1200 baud keyboard/printer to do my work while there were blazingly fast 9600 baud CRT’s locked up in the basement of the hospital, thanks to the centralists trying to shut down our system. They forbade us from sharing our software, which I termed “commiting portability.” The Washington, DC VA hospital’s minicomputer room was set on fire by an arsonist, a case never solved.
They took away my PDP 11/70 (almost a supercomputer at the time), and left me with a lowly PDP 11/34 (gasp). I used to fly up to San Francisco with a 5 mb disk drive (that’s MEGAbytes) holding an entire hospital information system at the time, to work with my buddy George Timson at the San Francisco VA hospital. We had purchased these systems as “word processors” that happened to have extra logic associated with them (enough logic to do an entire hospital information system, but the centralists had no idea of what was happening.) As a computer specialist, I was supposed to keep track of all the computing in the hospital, which meant inventorying all the calculators in the hospital. Somehow, I never go around to that inventory. Continue Reading »
I’m supporting the San Diego Science Festival, organized by my neighbor Larry Bock and the Biobridge program at UCSD. Larry noticed that they had huge science festivals in England, and in typical entrepreneurial style, started one here in San Diego. Balboa Park is one of the premier public spaces in the US, I think, so its wonderful to see the festival pretty much take over all the available open air space for over 300 booths and activities on April 4. They are projecting 30,000 people, but I suspect the tally will go much higher.
If we look a scale of human (or societal) functioning from -10 (really bad) to zero (normal) to +10 (really good), we find that most of our thinking is focused on moving things from the -10 to 0. The range from 0 to +10 is often ignored, or at least drowned out by all the mediagenic misery is so prevalent in the headlines. This is a deep subject that I’ve been concerned about for some time (I named the two ways of looking at things “benegnosis” – a way of knowing by what is positive and flourishing, and “malgnosis” – a way of knowing by what is failing.)
For the booth activities at the festival April 4, I’ll be arranging an experiment to look at whether happy people are more creative. I’m looking for volunteers for the event… see the Cosmos Research Center site for more information.
I saw this quaint video made by some astronaut, showing the bureaucracy at NASA:
It is a little rough around the production edges (Hint: get an external microphone), but still, it tells a great story, authentically. It certainly resonated with the many times I’ve tilted bureaucracies. (Coming soon: “Tom’s Rules of Engagement for Tilting Windmills: Lessons Learned in dealing with huge bureaucracies.)
I asked Peter Norvig, currently Director of Research at Google, and previously head of Computational Sciences at NASA, what he thought about the video, since he worked for both organizations shown in the film: Here’s what he said:
Peter Norvig, director of research at Google
I think it may represent a common pattern at JSC [Johnson Space Center]. For me at [NASA] Ames, the concerns were somewhat different. Ames is a Research Center, not a Flight Center, so our mix of funding and responsibilities is not the same.
At Google, I think the difference is not so much whether the manager supports the engineer,
nor if the manager
trusts the engineer to present her own work; rather it is the idea that the messenger doesn’t matter — I don’t care who the idea comes from, I just want to see metrics to help me evaluate whether it works or not. In that sense, everyone is on an even playing field. I’ve been pleased to see conversations of the form “I did this experiment and it fails; i think that proves we should go with your approach” and the reply “I’m not so sure — your approach
has some advantages over mine; what if we tried another experiment like this…”
Steve Jobs (L) and Steve Wozniak in 1977. Probably the only photo of Jobs in a necktie.
Steve Wozniak in 1977 announcing the Apple II
I’m amused that the Woz is going to appear on Dancing with the Stars. Here are some pictures of him and Steve Jobs I took in 1977, the day that they announced the Apple II at the First West Coast Computer Faire. The Woz is pretty much the geek’s geek, and has a great sense of humor. But somehow, I just don’t see him as a great dancer. Guess we’ll just have to see how he does. I wouldn’t be surprised if he tries to automate his dance partner’s dress or something like that.
I spent about an hour and a half with Steve Jobs that day, talking about how he was going to compete with IBM and other amazingly grandiose things. I went back up to Cupertino a few weeks later, but when I saw houses selling for $70,000, I decided going to work for them was out of the question (they had about 12 people in the company at the time).
These images and others are available for commercial licensing through Getty Images.
