I feel case accounts such as this, while admittedly anecdotal, may illuminate larger issues in medicine, healthcare information technology and leadership issues in both domains.
At "Should The U.S. Call A Moratorium On Ambitious National Electronic Health Records Plans?" I noted the appointment of a new Chief Information Officer for Health, a new leader for the massively troubled, multibillion dollar UK national electronic medical records program Connecting for Health (CfH).
The new leader had been a CIO at a candy and soft drink company as well as a gas and power utility. The are certainly fine qualifications to lead a national medical informatics initiative:
Christine Connelly was previously Chief Information Officer at Cadbury Schweppes with direct control of all IT operations and projects. She also spent over 20 years at BP where her roles included Chief of Staff for Gas, Power and Renewables, and Head of IT for both the upstream and downstream business.
The newly appointed Director of Program and System Delivery has a like background. Simply stunning. A multi-billion dollar EMR program on the verge of cancellation, with a history of ineffective leadership by non medical IT personnel, tries to redeem itself via the same old tired script despite ample availability of materials that suggest better ways, e.g. here.
Based on this type of story and my own anecdotal experiences, I am beginning to wonder if perhaps Europe has more dysfunctional attitudes regarding medical informatics expertise than the U.S.
For example, I'd personally been told several years ago that "there's nothing in my resume of value to a clinical research organization" by a British Sr. VP for Biometrics and Data Management of Europe-based CRO Icon Clinical who refused to speak with me directly (see "CRO's: we don't need Medical Informatics here.")
I've been told by a European GSK VP of Informatics & Knowledge Management who also refused to speak with me directly - even after an unsolicited call, interview and highly positive recommendation by GSK's own prestigious British retained recruitment firm - that my background was unsuitable for pharma informatics (despite my prior leadership role at Merck Research Labs - an American company!) This was because such work required someone with “an extensive CS background to write algorithms to solve business problems" (see my post "GSK, Avandia and Medical Informatics: More on Why Pharma Fails" for a series of significant questions raised by this information technologist's misinformed and profoundly tunnel-visioned view of Medical Informatics).
From another Europe-based clinical research organization: "Just wanted to follow up with you about the [informatics management] position. They sent us an e-mail today communicating that you are a great candidate but just a little too heavy on the Informatics side for this position."
Most recently, it happened again.
I've been told by another Euro company that I don't have enough experience.
I received an unsolicited message from Philips Research recruiting:
In the job description:
From: "Blimberg, Paul"
Date: 10/20/2008 03:39PM
Subject: Philips Research
We are presently conducting a search for viable candidates for our Open Head of Biomedical Research Informatics position (see attached). It was my hope that you may be able to recommend possible referrals or perhaps be interested yourself? Please contact me to discuss further.
Sourcing Team Lead - N.A.
Philips Shared Services - Recruiting
Title: Senior Director and Research Department Head
Group: Biomedical Informatics Research
The department performs research in areas of “representation, storage, retrieval, presentation, sharing, and optimal use of biomedical data, information and knowledge for problem solving and clinical decision-making”. Specifically, the research concentrates on clinical decision support. That is, the design, development, validation and evaluation of computer-supported software applications and solutions that unify knowledge discovery with engineering methods for deployment in the healthcare environment.
• Local Line management of technical professionals (MD/PhD/MS level);Program project management: project content, resources, staffing, funding, etc;
• Project renewal for value creation;
• Technical interaction and visibility in regional technical and professional organizations;
• Develop and manage research relationships with universities, scientific institutions, government contracts, etc.
• Establishing and expanding the IP portfolio for biomedical informatics and clinical decision support;
• Networking worldwide with Philips Research group leaders, project leaders and researchers to set the agenda and manage the relationships that will solidify and grow the CDS research activities.
Desired Candidate Background included:
• Experience in leading technical research in biomedicine driven towards clinical & business outcomes;
• Line management and strategy development skills;
• Technical recognition in field of expertise;
• PhD or equivalent in Biomedical Informatics or Biomedical Engineering with healthcare organizational experience; MD a significant plus;
• PhD in Computer Science will be considered if accompanied by significant work experience in healthcare or clinical medicine.
This was a good fit to my background. I wrote back:
Attached is my CV towards this position. I am a very close fit to its requirements, and in fact a key issue is my background not just in medicine and IT, but in electronics and telecommunications as well. I converse with technology professionals as easily as with medical professionals and executives, a skill that I believe is uncommon.
I proceeded to have an intensive telephone screen with the Philips recruiter, who then said he would pass along my CV to the hiring manager and team and that I would likely hear back in a few days or a week.
I have heard that line before, I thought.
After two weeks I heard nothing. I sent followup emails and voicemails on several occasions, still nothing in reply.
I had a strong feeling that the reason was going to be another case example from the "Medical Informatics Theater of the Absurd."
I finally sent a message expressing that I was "troubled" about not hearing back, and got the following reply:
From: "Blimberg, Paul"
Date: 11/12/2008 02:06PM
Subject: RE: Philips Research
We are still recruiting candidates for the role. I did also receive feedback from the team indicating that they would like for me to identify additional candidates with more established industry experience. Unfortunately, They will not continue to consider yourself and a few other candidates I have recently presented. So the quest continues.
As a former hiring manager in Big Pharma providing advanced informatics support for pharmaceutical research and development to 6,000 scientists worldwide, as well as being clinical IT project leader in an international collaboration with a Middle Eastern oil-producing country as well as at a number of large academic and non academic medical centers, I'm not sure what "more established industry experience" in informatics means ...
In any case, Philips was telling me I did not have enough experience, based on a piece of paper; the hiring manager or staff made this decision without any direct communications. It's not as if people with formal Medical Informatics backgrounds are falling out of the woodwork ...
I am beginning to sense a pattern.
What was the background of the hiring manager?
B.Sc. Honours degree in Physics and Music and a Ph.D. in the measurement of blood flow with ultrasound from University College Cardiff, U.K. ... was an ATL Ultrasound Technical Fellow and is a Fellow of the American Institute of Ultrasound in Medicine ... joined Research in North America in 2002 as Department Head in Healthcare Systems and IT to focus existing competencies in medical information technology ...
Notably lacking: formal credentials in medicine or Medical Informatics.
It's their company, but that doesn't stop me from asking probing questions. Being an inquisitive person, I wrote to the CEO of Philips Research, Peter Wierenga, PhD. After a short summary of the events above, I wrote:
Dear Dr Wierenga,
I note your opinion at this press release :Peter Wierenga, CEO of Philips Research adds: “ Talent is one of the essential drivers of our innovative power. Without talent there is no innovation."I tend to agree.
My question to you is: how can talent be evaluated from a paper CV and an HR conversation, without any direct contact between the hiring manager (presumably a domain expert) and a potential employee?
I claim it cannot, and will make the claim - in my opinion - that your personnel who believe it can be, as evidenced by their not even talking to several candidates with backgrounds similar to my own, may be causing harm to your company and to U.S. informatics efforts.
I await an answer to my question.
(I am assuming, of course, that what I was told was straightforward, and that there is no "sweetheart candidate" - with a sham recruitment process conducted to show that required internal hiring procedures were followed. This happens ... however, I will assume straightforwardness. I report, you decide.)
As bad as U.S. companies have been regarding informatics expertise, anecdotally the most intellectually challenged responses to medical informatics backgrounds I've experienced have indeed come from European companies. Ironically, the Saudis thought more highly of the field than the supposedly refined "from each according to their ability" Europeans, in my experiences as co-PI of informatics in the Saudi-Yale collaboration in clinical genetics.
I am also beginning to sense that the UK's massive problems in its Connecting For Health national EMR initiative may not be an entirely nonlinear phenomenon explainable only by chaos theory.