Health 2.0 & The Widening Digital Divide: A Call to Action
Too many years witnessing the same thing. First in the ACOR system. Then in many conferences about eHealth, e-Patients and now Health 2.0 and the Connected Health symposium at Harvard Medical School. Why is an entire segment of the US population almost completely absent from the fast evolving world of Health 2.0 and Participatory Medicine?
Participatory Medicine, Connected Health
The Center for Connected Health’s 2008 Symposium was held in Boston on October 27-28, 2008. I gave a talk entitled, “Participatory Medicine: How User-Generated Media are Changing American Attitudes and Actions, Online and Off.” As always, the conversations I had with people after the speech were the best part of the event.
Lena Sorenson, RN, PhD, an Associate Professor at the MGH Institute of Health Professions, pointed out that my 7-word challenge focuses on doctors and should instead focus on “providers” (doctors, yes, but also nurses, therapists, and every other health care professional who cares for people). I updated my slides before uploading them to the Pew Internet site to reflect that important change. Read more
Wall Street Journal goes e-Patient
Where have we heard this story before?
A friend of mine slipped on the sidewalk recently and broke her hip. She had surgery in one of the best hospitals in the country.
But it [wasn't their staff, it] was her grown daughter who noticed that she was having an adverse reaction to a pain medication. And that her IV drip had pulled out of a vein and was pumping her arm full of fluid. And that the hot compresses to reduce the swelling in her arm had left blisters on her skin. And that the blood-sugar test she was about to be given was meant for her roommate instead.
How can we have informed patients, if hospitals won’t inform?
This post is prompted by a horrid subject: how do we as a society deal with one of the worst possible events – a death in our healthcare system?
The immediate topic is a 37 year old woman who died last week at Beth Israel Deaconess Medical Center (BIDMC). An article in today’s Boston Globe discusses the hospital’s policy of openness about everything, even including tragedies. I think this policy is vitally important, though potentially very risky, and I want to say why I believe it’s so important.
The question that will make a difference is: What policies, what problem-solving approach, can possibly pull the American health care system out of the tangled, knotted, entrenched mess that it’s become?
Placebos & the Doctor-Patient Relationship
As the BMJ noted in its survey of physicians’ use of placebos this past week, the placebo effect is a powerful treatment. Judith Graham’s “Triage” blog examines this phenomenon and reminds us that it’s not the pill that’s causing the effect, but the attention to patient concerns: “In other words, it is the communication of caring, the feeling of being attended to, the transmission of confidence, the quality of the relationship between doctor and patient that holds the potential to ignite the placebo effect.”
Read the full entry: Placebos and the doctor-patient relationship.
A Glimpse of American Healthcare of the Future (My Talk at Health 2.0)
Thomas Jefferson had a radical notion: When the people are well-informed, they can be trusted to govern themselves. This powerful idea worked to end our rule by the King, but at the time it didn’t apply to slaves; it didn’t apply to women. It STILL doesn’t apply to patients.
I like that he used the word trust, by the way, perhaps the most used word at this conference. It isn’t just something we need to get from people in order to succeed. Trust is a two-way street. So is satisfaction.
In my lifetime, the primary focus of healthcare has moved, first from the hospital to the outpatient visit (”let’s do all we can to take care of people as outpatients”), then from offices and clinics to the home (most health decisions are made at home, often at the home computer). Today health is mobile; it is moving from the home to wherever people are. In other words, we are at the beginning of patient-centered medicine…
Connected Health Symposium 2008
An East Coast contingent of the e-patients group will be in Boston on Monday and Tuesday, speaking and listening at the Connected Health symposium.
I’m going to present the Pew Internet Project’s latest data on social media and how the participatory Web is creating opportunities for participatory medicine. Danny Sands and “e-Patient Dave” deBronkart will talk about “Illness in the age of ‘e’: A case study of participatory medicine.” I’ve been told there will be a roving microphone in the ampitheater, so I’m hoping a discussion erupts on either the grand themes (”Who Provides, Who Decides, Who Pays: Consumers, Clinicians and Business Models in the Connected Care Era”) or whatever else pops up. What would YOU ask if you had the chance to question the lineup of speakers?
“How to Take American Health Care From Worst to First”
What do we think of THIS?? An op-ed piece in the NY Times:Billy Beane, GM of the Oakland Athletics, suggests using baseball-style number-crunching to improve healthcare, with Newt Gingrich and John Kerry co-authoring the piece. Some snips:
“Remarkably, a doctor today can get more data on the starting third baseman on his fantasy baseball team than on the effectiveness of life-and-death medical procedures.”
“Franchises have used this data to answer some of the key questions in baseball: When is an attempted steal worth the risk? Whom should we draft, and in what order? Should we re-sign an aging star player and run the risk of paying for past performance rather than future results?
“Similarly, a health care system that is driven by robust comparative clinical evidence will save lives and money. …”
Quality of Care & e-Patients
JAMA has an interesting Patient Page on quality of care. The definitions of e-Patients and Participatory Medicine mention or point to quality of care. Are we talking about the same thing? NOT AT ALL!
If the patient page of JAMA represents the official position of the organization, which is almost certainly the case, we see how much work we still need have in front of us to change the mindset of many, if not the majority of, doctors.
41% of Adults are “Activated Patients”
The Center for Studying Health System Change has released another information-packed report, How Engaged Are Consumers in Their Health and Health Care, and Why Does It Matter. The researchers created a “Patient Activation Measure” and apparently 41% of adults are what we might call e-patients (empowered, equipped, etc.).
The Center for Studying Health System Change: Level of Activation for U.S. Adults, 2007
white paper
e-Patients:
How They Can Help Us Heal Healthcare
