Creativity: Where Good Ideas Come From Bruce L. Rollman, MD, MPH - - PowerPoint PPT Presentation

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Creativity: Where Good Ideas Come From Bruce L. Rollman, MD, MPH - - PowerPoint PPT Presentation

Oct 12, 2023 20 likes •774 views

Creativity: Where Good Ideas Come From Bruce L. Rollman, MD, MPH UPMC Endowed Chair in General Internal Medicine Director, Center for Behavioral Health and Smart Technology Professor of Medicine, Psychiatry, Biomedical Informatics, and

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Bruce L. Rollman, MD, MPH

UPMC Endowed Chair in General Internal Medicine Director, Center for Behavioral Health and Smart Technology Professor of Medicine, Psychiatry, Biomedical Informatics, and Clinical and Translational Science

Creativity: Where Good Ideas Come From

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Where Good Ideas Come From

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Chance favors the prepared mind

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“What is imagination? It is the Combining faculty. It brings together things, facts, ideas, conceptions in new, original, endless, ever-varying combinations….”

Ada Lovelace, 1841

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Where Good Ideas Come From

1) Curiosity 6) Follow the literature 2) Reading 7) Serendipity 3) Preparation 8) Networking 4) Environment 9) Travel 5) Associative 10) Community thinking service

Selective Travel
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1) Curiosity

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2) Reading

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3) Preparation

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4) Environment

Joined DGIM July 1995

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4) Environment

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5) Associative Thinking

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My first PC - 1984

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Freshman Anatomy - 1985

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5) Associative Thinking

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My First Patent - 1989

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1991 1994 1997

My Next Patents

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I wrote an R01 grant my first year

  • n faculty.
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Depression Care Using Computerized Decision Support

AHCPR R01 HS09421

($642,000 over 3 years)

It was funded on 1’st submission

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Men·tor (mĕn'tôr', -tər) n. †

  • 1. a wise and trusted counselor or teacher.
  • 2. an influential senior sponsor or

supporter.

† Dictionary.com

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10 12 14 16 18 20 22 24 3 6

HRS-D by Intervention

N=200 Month

Active Care Passive Care Usual Care Rollman BL, et. al. J Gen Int Med. 2002; 17:493

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Why Didn’t This Work?

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6) Follow the Literature

  • TOC list servs
  • Citation alerts
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Wagner Chronic Care Model

www.improvingchroniccare.org

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“Collaborative Care”

  • Population perspective
  • Linked to primary care
  • Team approach
  • Considers patient preferences
  • Proactive
  • Information technology

Coleman K, et al. Health Aff. 2009; 28:75

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Objective:

Compare 12-month outcomes for patients with PD and/or GAD, cared for by PCPs informed

  • f their diagnosis, and randomized to either:
  • 1. A telephone-based collaborative care

strategy for treating PD/GAD; or

  • 2. Their PCPs’ “usual care” for PD/GAD

Improving Quality of Primary Care for Anxiety Disorders

NIMH R01 MH59395: 9/99-2/04

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5 Collaborative Care Trials

1999-2004: Improving Quality of Primary Care for Anxiety Disorders 2004-2010: Reduce Limitations from Anxiety 2012-2017: 2003-2009: Bypassing the Blues 2013-2018:

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“Patient-Centered Medical Home”

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The Bypassing the Blues Trial

Telephone-Delivered Collaborative Care for Treating Post-CABG Depression

R01 HL70000: 7/1/03-6/30/10

BL Rollman, B Herbeck Belnap, PR Houck, S Mazumdar, PJ Counihan, HC Schulberg, WN Kapoor, CF Reynolds III

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Telephone treatment of depression following cardiac bypass surgery speeds recovery

JAMA November 18, 2009

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19+ Years Effort

3/98: First thoughts of depression and CVD 7/98: Submit proposal to American Heart Assoc. 9/98: AHA rejects application; start raising pilot $ 1/99-01: Conduct CABS pilot work 6/01: R01 submitted; 10/01 unscored 7/02: R01 resubmitted; 7/03 funded 3/04: Start recruitment 6/08: Complete 8-month f/u; open study blind 3/09: American Psychosomatic Society presentation 11/09: JAMA ‘Main Outcomes’ publication 9/14: GHP Cost-effectiveness publication 2/17: 10-Yr Mortality paper under review

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7)

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One day. . . .March 1998

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7) Serendipity

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Bruce L. Rollman, MD, MPH Bea Herbeck Belnap, Dr Biol Hum Kaleab Abebe, PhD John M. Jakacic, PhD Jordan F. Karp, MD Matthew F. Muldoon, MD, MPH Ravi Ramani, MD Charles F. Reynolds III, MD Kenneth J. Smith, MD

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“The Checklist”

A) ACE/ARB D) Depression (PHQ-2/9) B) Beta-blocker E) Exercise (cardiac rehab) C) Clotting (ASA) F) Financial (afford meds) C) Cholesterol (statin) F) Follow-up (appt.)

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2) Reading 5) Associative Thinking

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8) Networking

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9) Travel

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Sabbatical

6/06-2/07

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NHS Technology Appraisal

http://www.nice.org.uk/TA97#documents

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Computerized CBT (CCBT)

http://www.beatingthebluesus.com/

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5) Associative Thinking

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Internet Support Groups

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Internet Support Groups

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Trends in Collaborative Care

“1.0” Face-to-Face “2.0” Telephone-Based “3.0” On-Line

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Bruce L. Rollman, MD, MPH Bea Herbeck Belnap, Dr Biol Hum Jordan F. Karp, MD Kaleab Abebe, PhD Armando J. Rotondi, PhD Kenneth J. Smith, MD Michael B. Spring, PhD

NIMH R01 MH093501

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Internet Support Group

Desktop View

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Internet Support Group

Smartphone View

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2) Reading

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A-B Test Color

Blue vs. White background

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Other A-B Tests

  • Subject line
  • Salutation
  • Hey, Hi, Hello, Dear…
  • Altruism
  • “Help you” vs. “Help others…”
  • Prize amount
  • $15 vs. $0
  • $10 gain vs. $10 loss
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Participation Inequality

“The 1% Rule”

Superusers (1%)

382 Posts+Comments (40% of postings)

Top Contributors (9%)

42 Posts+Comments (38% of postings)

Contributors (41%)

5 Posts+Comments (22% of postings)

No Log-Ins (22%)

Mean: 9.4 Posts + Comments per OT member

Observers (27%)

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5) Associative Thinking

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Recruitment is Challenging

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Epic “Best Practice Alerts” to Identify Patients

Rollman BL, et al. J Gen Int Med. 2008; 23:447

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BPA Recruitment Efficiency

Waitroom-Staff Best Practice Alert

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BPAs Catching-On

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10) Community Service

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10) Community Service

  • Review papers and grants
  • Committees
  • National organizations
  • Community volunteer
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10) Community Service

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10) Community Service

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A Few Closing Thoughts…

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Chance favors the prepared mind

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Hard Work Genius is 1% inspiration and 99% perspiration

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Lot of Time

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Family Support

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Family Support

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Family Support

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Time Flies…

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Enjoy the Journey

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Thanks!

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Where Good Ideas Come From

1) Curiosity 6) Follow the literature 2) Reading 7) Serendipity 3) Preparation 8) Networking 4) Environment 9) Travel 5) Associative 10) Community thinking service

Selective Travel