Google Forms Advisory Council Heavy on Bigwigs
Well, at least Google tries. We have to give them credit for that, and for this very first step — which I honestly hope is just that (as others have suggested giving Google the benefit of the doubt) — it’s a doosey. They’ve gone and created an advisory council to help guide them in their thinking in health.
But in a very traditional, Big-Company-Hey-Maybe-a-Little-Evil-Won’t-Hurt-Us way, they didn’t fill such a council with patients and patient advocates. Instead, they filled it with doctors and doctor insiders (and, of course, a representative of Wal-Mart!), because who better to help Google figure out health than docs?!
Gee, I dunno. How about the people who’ve been the unhappy recipients of such a system for the past 3 or 4 decades?
Sandy over at Junk Food Science has some immediate concerns about the road this leads Google down, namely one of censorship and not helping people find all health information:
Screening out “irrelevant” and “unhelpful” information? That sounds like a euphemism for censorship.
I also blogged about the Google Goof on World of Psychology.
A for effort, D for implementation.
Michael Moore’s Sicko Wants You
Michael Moore has decided to do something a little different with the recent release of his documentary detailing some of the ills, as he sees them, of America’s healthcare system. He has encouraged individuals to upload their own healthcare horror stories to YouTube.
This is an interesting use of the Internet to help tell a continuing story, since obviously one film can’t capture all that’s wrong with our health care system. What I would also find interesting is if people added their own experiences about what works in the current U.S. system. Because wholesale changes — such as completely changing how the industry works here — aren’t nearly as likely as progressive, smaller changes.
I haven’t caught the film yet, but hope to do so over the weekend. Let us know what you thought of the film in the comments below, and what you think of this YouTube effort.
Health Education vs. Outcomes
The Pew Internet Project has found that the internet has a significant impact on some life decisions (which school to attend, for example), but it does not play a big role in other “major life moments.” Is there something similar in health care? Are there conditions and diseases which are more likely to yield to an e-patient’s ability to change the outcome? Is it enough that e-patients are more informed and feel empowered by information, or should we expect more?
I was reminded of these questions when I saw the current issue of the British Medical Journal. If only the cover story were as arresting as the cover image of a giant pregnant belly. A randomized controlled trial found, once again, that pregnant women who are given decision aids about VBAC are more likely than the control group to be informed about their choices, but no more likely to have a different outcome. Two editorials accompany the article and both are worth reading, along with the study (see: Evidence to inform and Decision aids for women with a previous caesarean section).
AMA versus Retail Clinics: Patient Safety or Protectionism?
Unsurprisingly, the American Medical Association has come down on the side of paternalistic “patient safety” (just looking out for us little ole “patients”) in expressing concerns about the rise of retail clinics for minor health concerns, as noted in this article in The Chicago Tribune:
The AMA’s policymaking House of Delegates, meeting in Chicago, said lack of regulation at retail clinics might be fostering liability concerns, health risks and potential conflicts of interest between the clinics’ nurse practitioners who order prescriptions and the pharmacies that fill them. Often, the clinic is near the pharmacy counter in those retail stores.
At present, most of these retail clinics can be found in stores like Wal-Mart or the like, and are open every day with no appointments necessary. The clinics feel this opens up patient care to a wider audience, and insurance is often accepted just at a doctor’s office. Otherwise, the service can be cheaper than a doctor’s visit, at around $60/visit. The clinics treat patients with routine maladies and are under physicians’ supervision, although doctors usually are not actually in the clinic. Most clinics are for ailments such as ear and sinus infections, strep throat and athlete’s foot.
Obvious protectionist measure? Is patient care or safety really in jeopardy if they’re treated for athlete’s foot in one of these clinics?
The nice thing about this model is that the market will tell us whether there’s enough demand to make these clinics viable in the long-term. It worked for optometrists. But if nobody goes to these retail clinics (or not enough people go), they won’t be around for very long.
E-Patients And The Participatory Internet- Part II
In a post a couple of weeks ago (Part I), I talked about the participatory nature of the internet and related platforms. OK, I agree that “Web 2.0″ is already becoming a somewhat empty concept, as some of my colleagues have noted on this very site. No matter your opinion of that catchphrase, the point is that many commercial proponents of Web 2.0 have become aware of e-Patients. Here is an example.
Three Simple Rules
Don Kemper, CEO of Healthwise, calls on us to continue the debate that he & Tom began many years ago with a post about his “Three Simple Rules”:
The Self-Care Rule: Help people do as much for themselves as they possibly can.
The Guidelines Rule: Help people ask for the care they need.
The Veto Rule: Help people say “no” to care they don’t need.
“Communication between Physicians and Patients in the Era of E-Medicine”
The New England Journal of Medicine has a “Perspective” by John H. Stone, M.D., M.P.H., on how E-Medicine is changing the doctor-patient relationship (June 14, 2007). Here’s a memorable quote: “The ‘laying on of hands’ will increasingly include the pressing of keys.”
Where Online Health Will Be
Tom Ferguson’s White Paper, “e-patients: how they can help us heal health care,” was many years in development. Early in the process Tom convened a gathering at Commonweal in Bolinas, CA. He invited many of the people who came together to form the “e-Patients Scholars Working Group.”
In addition, Tom included John Fiorillo, a consultant to the Robert Wood Johnson Foundation. Since RWJF was funding the project, Tom felt that it was important to have John’s perspective.
One of the memorable comments John made at that meeting so many years ago used the metaphor of Wayne Gretzky, the hockey legend. He pointed out that Gretzky was never skating to where the puck was, but rather to where it would be in the future. That is why RWJF had funded an investigation of online health. John wanted to know where online health care would be in a few years.
Not surprisingly, Tom Ferguson was the medical equivalent of Wayne Gretzky. Tom realized the power of the Web almost immediately.
An article in the Wall Street Journal by William M. Bulkeley, “Playing Well With Others,” describes how IBM is using Second Life as a powerful social networking tool. http://online.wsj.com/article/SB118194536298737221.html
One of Tom’s e-Patient Scholars is John Lester. After helping start Braintalk at Harvard with Dan Hoch, MD, John went to work for Linden Labs, the company that created Second Life. John has taken social networking to the next level for e-patients. He has developed online virtual communities for people with Asperger’s syndrome and cerebral palsy.
The IBMers have 50 “islands” in Second Life and use them for lectures, group discussions and worldwide meetings. They are also using wikis for collaborative research. Tom envisioned all of this as making a major contribution to online connectivity and support among patients. It is fascinating to see that companies like Big Blue are catching up. Now let’s hope that our health leaders will recognize the power of these online tools.
How do you afford healthcare for so many people?
Bloggers at “Et tu?” are discussing Healthcare costs these days and came to the conclusion that one way to help reduce Healthcare costs is by using trusted Internet sites such as WebMD and DrGreene.com. You can read or join the discussion at “Et Tu?”
What is the Place of Complementary and Alternative Medicine?
I have puzzled over this question many times. Today, I found a web site called “The New Medicine” that was based on PBS documentary that has a lot of balanced content about the role of CAM in patient care. I think it is worth a look!
-Charlie Smith
white paper
e-Patients:
How They Can Help Us Heal Healthcare
