Search Results for: "best care at lower cost"

December 14, 2012 By e-Patient Dave 15 Comments

Best Care at Lower Cost: As the crunch hits, will the best survive?

Update 12/16: comments below this post have added more detail and documentation.

On one level this is a happy post. On another level, it’s a storm warning.

The happy part:

Of all the amazing, inspiring, humbling things that have happened in this three year adventure, one of the best is being invited to participate in discussions with professional societies I respect. For instance, twice this year I’ve written for the SGIM Forum, published by the Society of General Internal Medicine. Real medical leaders are actively listening for the patient’s perspective on many aspects of the challenges facing health and care, especially in America.

For the current issue (December 2012 – click image at left) I was invited to write a post-election perspective for their Health Policy Corner on the outlook as reform rolls out. The angle I chose was to ask, as the new rules unfold and the business of medicine changes, will the best providers be protected?

It was a riff on the Institute of Medicine’s new report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. The most-quoted item in that report is that we have $750 billion of excess spending in American healthcare.

And that’s a problem. A big one.

The storm warning:

$750 billion is an incomprehensible number; it’s impossible to imagine how much financial pain there will be as we work to fix it. So I put it this way: if Intel, Microsoft, Apple, GM, IBM, Ford, Chrysler and Dell all went out of business, it still wouldn’t add up to that much.

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Patient Perspectives Advisor

Client meeting 2013 For decades thought leaders like Dr. Warner Slack have said patients are the most under-used resource in healthcare. He was talking about health IT, but now the new role of the patient is mainstream.

In 2012 the Institute of Medicine published a major report, 382 pages long, called Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, which said, right up front (Table S-2 in the Executive Summary): of the four pillars of the future of medicine, #2 is …

Best Care at Lower Cost cover — Click to purchase original report on the National Academies Press website

Patient-Clinician Partnerships

Engaged, empowered patients—A learning health care system is anchored on patient needs and perspectives and promotes the inclusion of patients, families, and other caregivers as vital members of the continuously learning care team. [emphasis added]

Anchored on patient needs and perspectives – not as a last-minute thing; anchored there, from the start.

The problem is that culture change doesn’t spread fast (most people have never seen that statement), and it leaves us with the question: How do you do that? What do they mean by that?

As a former product manager in my pre-cancer life, I understand business perspectives, customer relevance, and good user experience. So, to supplement my speaking income I offer advisory contracts to companies and academic grantees working on all aspects of patient-centered thinking and patient-centered care. In short, I advise on “patient needs and perspectives.”

For additional background, I serve on the BMJ’s patient advisory panel, interacting with some of the world’s most activated patient voices, and have spoken with audiences at nearly four hundred conferences in fifteen countries and participated in a hundred other events. Contact me to discuss whether your project could provide mutual value in these changing times.

Advisory work – present:

Advisory contracts: MyHealth.US
Pro bono advisory: OpenNotes advisory board
Disclosures / COI: See the disclosures page.

Advisory work – past:

Advisory boards: Hello Doctor; AdhereTx (now ActualMeds); Happtique Certification Program Blue Ribbon Panel, HealthMonitor, Antidote (formerly TrialReach) (Special Advisor for Patient Perspectives),
Grant-funded projects: Bridging the Gap care transitions study, University of Texas School of Nursing; National Integration Academy Council (steering the creation of AHRQ’s Integration Academy); DECIDE-PCI project, U of Missouri.

Working groups:

None at present.

May 18, 2016 By e-Patient Dave 5 Comments

“The Patient’s Perspective – medicine’s new true north” – essay in PLAID diabetes journal

For the past year I’ve mentioned this in speeches, but I’ve never written about it here:

In November 2014, a routine blood test revealed that my hemoglobin A1C was slightly elevated, making me what they call “pre-diabetic.” (See lab results below.)

Well, that got my attention.

Why? Because, through social media, I know a lot of really smart, articulate, passionate members of “the DOC” – the diabetes online
community – and I’ve learned all kinds of things about the reality of diabetes that you don’t see in the TV commercials. A1c screen capture

I’ve learned that it’s not rare for a basically “healthy” person with diabetes (PWD) to die in their sleep when their blood sugar crashes; I’ve learned about unfixable nerve pain and amputations; I’ve learned about all kinds of things that can go wrong when diabetes gets out of control. I don’t even know enough to make a properly prioritized list, but I know enough to say you do not want to have diabetes if you can avoid it.

(Footnote: it drives many of us nuts when a TV commercial or news story talks about “diabetes” as if it were one thing. It’s not. Type 1 diabetes (T1D) is medically different from type 2 diabetes (T2D), which I am at risk for; it typically arises in middle age, but has been seen as young as age 3. “Diabetes prevention” is an ignorant thing to say: Type 1 can’t be prevented, Type 2 sometimes can. But that’s a rant for another day.)

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February 5, 2016 By e-Patient Dave 7 Comments

“Knowledge is Power. Power to the people.” (Guest post for Philips Healthcare)

For healthcare to achieve its best,
empower the patient and family.

Here’s a composite of four quote graphics Philips tweeted yesterday for World Cancer Day:

Memes Philips tweeted with links to the post

I’ve had the good fortune to cross paths with Philips Healthcare several times, most recently for a speech (video) at the big RSNA radiology convention in Chicago. I just love what they’re doing in partnership with REshape and Innovation Center at Radboud UMC, where my crazy-amazing friend Lucien Engelen is rapidly creating the future of health and care with Philips and Salesforce.com. Seriously: watch what will come out of that threesome!

So when Philips asked me to do a guest post for yesterday’s global #WorldCancerDay, I said sure. It ran on their blog yesterday.

“Knowledge is Power. Power to the people.”

For healthcare to achieve its best, empower the patient and family.

When social change meets innovation, new things become possible. That’s what’s happening in the patient world, as “participatory medicine” is empowered by patient access to all kinds of useful information.

When the Web was born the term e-patient was coined by “Doc Tom” Ferguson to describe a new kind of patient, no longer in the dark but thoroughly empowered to achieve new things – because they have unprecedented access to information. The idea has matured and deepened, and now, ten years after Ferguson’s death, is coming of age with the signature catch-phrase ‘empowered, engaged, equipped, enabled’.

It’s a moment we should celebrate, because for too long medicine has edged away from the changing landscape of consumer power. Every industry from music to travel to supermarkets has gone digital, sharing knowledge and power and flexibility with their consumers, but medicine has lagged behind: many are not on board, and it’s holding healthcare back.

This is serious stuff: the information revolution has touched my medical life more than once – sometimes in life-saving ways:

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June 3, 2015 By e-Patient Dave 2 Comments

My comment submitted for Meaningful Use Stage 3 last week

This is long but if you’re interested in patient data access I hope you’ll find time to read it. Something important is afoot in federal policy.

Updated 6/4 – added a link to a doctor’s blog post

Over on e-patients.net, the blog of the Society for Participatory Medicine, for weeks there have been blog posts about an important moment that’s happening right now in Federal health policy. The details are complex and geeky (imagine that, with Federal policy) but here’s a tiny tiny nutshell, for readers of this blog:

In the 2009 federal stimulus bill (not as part of Obamacare), billions of dollars were designated to help doctors and hospitals finally computerize.

To get the money, they have to not just buy the system and let it collect dust; they have to put it to “meaningful use” – “MU,” as it’s often known.

Not surprisingly, what you have to do to get the money is a topic of hot debate and much lobbying.
- Remember your civics class? The Legislative Branch writes a bill, and then in the Executive Branch, regulators write the regulations that put the law into action. The regulators get to say specifically what’s legal and what’s not. (See, lobbyists aren’t just on Capitol Hill – they talk to the Executive Branch too.)

An important part of this discussion for several years has been whether they have to give you and me our data that’s in their systems. Basically: can they use those systems to create your medical record, hoard it (keep it from you), and still get their federal reimbursement??

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