Patient Voices at CHCF’s Chronic Disease Care Conference
This is the second in a series of posts about the California HealthCare Foundation’s Chronic Disease Care conference (the first was Happy Dogs in a Pile of Sticks).
Patient Voices: Managing Chronic Conditions, Living our Lives
Ted Eytan snapped a photo that captured this session: Patient Involvement Makes People Smile
Here is each person’s story: Read more
In the Spin II: You and Your Billing Code
Pass the Valium!
Previously on e-Patients.net I recounted the crazy-making quest for a second opinion on an abnormal mammogram (microcalicifications) as per the advice of New York Times health columnist and breast cancer survivor Jane E. Brody. The gynecologist who ordered the mammogram refused to authorize a second opinion, however, deferring to the radiologist, who referred me back to the clinic and so on and so forth.
My primary care provider, who carefully reviewed the films and reports (sans compensation), thought a biopsy might be the safe thing. She was not the referring entity, however. The clinic was !#$^%$#@
I started over, skipping a few bases, securing a first-rate surgeon at the county hospital as the new referral entity. In a futile attempt to waste no one’s time except my own, I hand-carried a disc of the imaging studies to the appointment.
Right?
Wrong!
Read more
Saving Lives, Old-School Style
What if there was a simple, old-school style procedure that could save tens of thousands of lives every year?
Better yet, what if it could be implemented at minuscule costs (about $3 million to rollout nationwide), and would require very little change in anyone’s procedure or daily lives?
What if that procedure was something as simple as going down a checklist before running any procedure on a patient?
Virtual Participatory Medicine Town Meeting
On Friday Senator Tom Daschle announced a campaign to get input from the public about what healthcare reform should look like. “The Transition will host Health Care Community Discussions across the Country over the holidays this December to help his Policy Team put together their final recommendations for the New Administration.”
What a novel approach. What a change from the past when plans were written behind closed doors with little or no input from the public, i.e. the people whose lives are being impacted by the healthcare decisions being made.
They want people to host Health Care Community discussions in our homes and in our neighborhoods between December 15 and December 31. Could we host a virtual one? Or at least a virtual extension of a physical one?
(I’d also like to host one in my home, official or not. You’re all invited.)
It is thrilling for the public to be invited to participate in the discussion, but with the invitation comes the responsibility to do something. Perhaps we could use this blog to come up with ideas to answer their request — grand ideas, down to earth ideas, crazy no-way-in-the-world to implement ideas, practical ones that may seem too small to consider. Let’s take this on as a “you asked for it” challenge.
Perhaps, the change that was promised, will be delivered.
A Fatally Flawed Medical Educational Model
This week, many news outlets reported on how residents should be given 5 hours of sleep after working 16 hours straight.
Think about that for a moment.
In what other job — any job in the world — would it be acceptable to even use the term “after working 16 hours.” The 16 hour workday went out with the Industrial era here in the U.S. (Residents can actually be required to be on-call for up to 30 hours at a time on a single shift, which is even more absurd.)
“I can buy a damn good amputation…”
Paul Grundy MD, of IBM, chair of PCPCC, is interviewed in the current Crain’s Benefits Outlook, a business publication about employee benefit programs. This quote alone is worth the price of admission:
I can buy a damn good amputation for my diabetic, but what I can’t get is a good system in place to prevent my diabetic from needing the amputation. We don’t reward a system in which comprehensive coordinated care and robust prevention is valued.
Amen. What are we thinking, insurers, when we fund treatments instead of preventing them??
“The Evidence Gap”: Pharma impedes patient access to better treatment
A lot of effort and study is going into improving healthcare and untangling its cost structure. So methinks it’s nearly criminal when someone blocks adoption of a treatment that’s better, especially when it’s also less expensive.
Case in point, from yesterday’s NY Times: The Evidence Gap: The Minimal Impact of a Big Hypertension Study
The surprising news made headlines in December 2002. Generic pills for high blood pressure, which had been in use since the 1950s and cost only pennies a day, worked better than newer drugs that were up to 20 times as expensive.
The findings, from one of the biggest clinical trials ever organized by the federal government, promised to save the nation billions of dollars in treating the tens of millions of Americans with hypertension.
Six years later, though, the use of [diuretics] is far smaller than some of the trial’s organizers had hoped.
What?? I use diuretics, prescribed by my e-patient doc, Danny Sands. Doesn’t every BP patient? They reduce water content in the body, lowering blood pressure. Why isn’t every BP patient doing this?
Information Silos Are Everywhere. But So Is The Internet!
Information Silo: An information silo is a management system incapable of reciprocal operation with other, related management systems… “Information silo” is a pejorative expression that is useful for describing the absence of operational reciprocity. Derived variants are “silo thinking”, “silo vision”, and “silo mentality”. (from Wikipedia)
Although much has been written about them, information silos are becoming far more recognized as the major reason why organizations are unable to take full advantage of the Internet’s power to interconnect business processes.
One of the great presentations at the Connected Health Symposium was “Illness in the Age of “e”: A Case Study in Participatory e-Medicine”, a conversation between e-Patient Dave deBronkart and his PCP, Danny Sands, M.D., MPH, who shares his time between a general internist practice at Beth Israel Deaconess Medical Center (one of the Harvard teaching hospitals), and serving as the Senior Medical Informatics Director at Cisco Systems. Danny is also an early proponent of patient empowerment and one of the authors of the e-Patients White Paper.
Happy Dogs in a Pile of Sticks (Spreading Improvement in Chronic Disease Care)
The California HealthCare Foundation’s Chronic Disease Care conference was so packed with great panels that I needed help choosing my targets. Here is the first in a series of posts about this event.
Spreading Improvement: After the Innovators/Early Adopters
Read more
How Good Are Doctor Rating Sites?
Ruth Given has written a paper entitled, MD Rating Websites: Current State of the Space and Future Prospects (PDF), that was recently published on THCB. It’s a 39-page informal analysis (with an emphasis placed on informal) that takes a fairly good and comprehensive look at the space of doctor rating sites as they exist today.
I think that the main issue Given hit upon in the report (but I’m not sure she recognizes as the primary challenge of doctor rating sites) is the numbers issue. With over 700,000 physicians in the U.S., a ratings database of 10,000 or even 20,000 is pitifully and woefully small.
And not only is such a number small, it is statistically troublesome, likely painting an inaccurate picture of providers listed. If most sites only have one or two ratings for any given physician (and such data is statistically useless, if the average family physician is covering between 2,000 to 2,500 patients), then the sites themselves provide little added value outside of the directory listing. Which, as Given notes, is inaccurate or nonexistent more often than not.
white paper
e-Patients:
How They Can Help Us Heal Healthcare
