The Karma Initiative

kar•ma [kahr-muh] Theosophy: The cosmic principle according to which each person is rewarded or punished in one incarnation according to that person’s deeds in the previous incarnation.

We are the Center for Biomedical Informatics at The Children’s Hospital of Philadelphia. We turned 5 years old this month! It has been a spiritual journey, one which we hope to share with you over the life of this blog, and one in which we have learned many life lessons. In the end, these lessons have made us better as informaticians, and I think it is safe to say that they have matured us both as an organization and as people.

A few years ago, I playfully coined the term “Karma Initiative” as a metaphor for our quest, a sort of idealistic kumbayah of ideas and technologies that magically comes together to help transform an institution into a data-aware hospital. This was a pun on the mysterious Dharma Initiative of the popular Lost television series as well as the popularized western version of the concept of karma, essentially a belief that effect is fated as a response to intended cause. But the underlying purpose was to try to capture and label the essence of the general success CBMi has enjoyed in its first half-decade of existence. How could we distinguish the principles that led to positive outcomes for our informatics projects from those that didn’t work?

In our observations, the commonality of success for our projects so far has had little to do with technology stacks, core algorithms, or star schemas. It has had everything to do with behavior modification. We have been successful only if we managed to change a workflow, whether that meant getting a researcher to use a tool, overhaul a process, or make a new discovery. What we’ve realized is that technology alone can’t change this, no matter how “facile”, “interoperable”, or “seamless” it is. Culture change has an associated activation energy that serves as a barrier to adoption. Just like riding a bike up a hill, a researcher must strongly desire to get over the hill, as well as to be provided the energy it takes to get there.

To receive good karma requires positive action, not just good intent. How do we measure positive action? As we’ve progressed, the questions we find ourselves posing to new collaborators have evolved, and they have increasingly been focused on the culture:

“How do you see others using this, and why”?

“Who is your audience, and how will you reach it”?

“In what ways would success change your lab”?

These may be Product Development 101 principles, but that isn’t exactly our training. We are just now realizing that the Behavior Modification chart may be more important than the Gantt Chart, and for some of us, it was a hard-earned lesson.

In subsequent blogs, we plan to discuss what has worked for us along with what we think might work. We’ve certainly made our share of mistakes. We’ve built and discovered things that turned out to not be as interesting or cool to researchers as we thought. We’ve also engaged folks who turned out not to know what they wanted or why they wanted it. But we’ve also seen many projects to fruition that have been real achivements. And we’ve managed to grow our Center appreciably in our short lifespan, so we must be learning.

Hopefully, some of these thoughts will resonate with you. Hopefully, you will be able to share with us what you’ve learned as well, so we can all move on to the next level.

Happy Fates,
Pete for CBMi

2 Responses to The Karma Initiative

  1. Susan Becker says:

    the comment you made “We’ve also engaged folks who turned out not to know what they wanted or why they wanted it” resonates with me but maybe not for the reasons you might assume. For us to reach Karma, I feel that judgement of others purpose is a real barrier to moving forward. In research, there is value in asking the wrong questions at times , so others should not judge the researchers of “not knowing what you want”. Frequently the innovations with the biggest impact in the past history of research, have been reached serindipidously. A discovery made on the wrong path…. or an unexpected answer found in the quest for something else….Sometimes one can not understand the data until one asks some questions about it and finds that they are are thinking about it the wrong way because they get an answer that is not expected.
    There is value in the journey.

  2. Pete White says:

    Hi Susan,

    This is a great point, and probably a good basis for another blog post at some point. In our experience, when designing data systems, the core user group is often focused on the ability to answer pre-defined questions. This is an important process, and having a good set of use cases that can validate a data solution is an absolute requirement for widespread adoption and success. But you are absolutely right that “query known” is only part of the equation, while “query unknown” often leads to more compelling science. With this is mind, we’ve been recently designing systems that seek to immerse researchers in their data, but in a way that is unconstrained, so they can explore the data for their own purposes. We feel that this approach creates an environment that promotes data discovery and hypothesis generation, which is what I think you are talking about. As you will see in upcoming posts and news, we are now rolling out some resources that we think will help with this aspect of research. You can check out an early prototype at, and our general framework (called Harvest) will be released soon.


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