Laboratory Bench Research, the SDMM, and the Most Important Hurdle

Here’s my first blog post. This not-so-new technology is magic to those of us familiar with the pre-internet era. Here's something from my background to address a first question I hear often: "Why are you doing what you're doing?!” 

In college I found myself really enjoying laboratory “bench” research. We studied a “living fossil," a single cell organism that contained a cyanelle. This cyanelle was thought to be a step in plant cell evolution. It had characteristics similar to a blue green algae that may have been "eaten" by the organism. It then perhaps gradually evolved into modern day chloroplasts, those energy producing units in all green plants. Looking at the cyanelle's RNA could give us some clues about this possibility.

The experiments followed a careful protocol. There was an exact amount of solution, at a specificpH (better not mess that up), and a series of steps to be executed as precisely as possible. Then the extracted RNA was put on a gel electrophoresis to generate a pattern. This could then be compared to the RNA pattern of modern-day chloroplasts.

The RNA patterns turned out to be similar, between the more primitive cyanelle and today's chloroplast. It is hard to explain my excitement when discovering this finding, tracing prehistoric plant life to our modern gardens. (OK, exciting only if you are into that stuff.)

While I loved the bench research, I opted for medical school and patient care. But there was one aspect of the lab that I constantly wanted as a doctor. My hectic clinical care couldn’t be further from the clean (usually), organized (mostly) science laboratory. It bugged me no end that systems weren't more structured, more “scientific” in clinical care – especially when applied to  information management. I found myself making non-optimal decisions simply because easily attainable pieces of information were missing.

The drive to bring better organization to clinical care has pushed me for over 30 years to research and develop the Siebens Domain Management Model (SDMM). The SDMM's four domains (and sub-domains) can help to introduce a more systematic approach especially with more complex patients. The SDMM is designed to address our collective challenge to better manage health care by introducing one important kind of standardization.

I know I am not alone in searching for better organization in clinical systems. Just a few weeks ago, the theme was echoed in a public health lecture which touched on research by The Advisory Group. In its survey of 160 health care industry leaders there was general  acknowledgement that clinical standardization is the most important hurdle to integrating health care services. Maybe some of those leaders, like me, really enjoyed lab bench research with clear protocols.