e-Patient Dave

Power to the Patient!

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“For-profit hospice is a vast crime scene, and private equity is holding the knife”

Screen capture of New Yorker article headline

Good hospice can be immensely valuable. But there are predators.

A wise friend referred me to this New Yorker article last month about a Pro Publica investigation. I skimmed it then, and today I read it in full. It’s appalling. If anyone you know is considering hospice, or has been “invited” by a company to consider it, beware. Here’s what the friend basically said – and they were right:

For-profit hospice is a vast crime scene,
and private equity is holding the knife

Note, I’m talking (and the article talks) about for-profit hospice companies. For-profit hospice chains bill the government four times more per patient than not-for-profits, and focus on both maximizing admissions and cutting costs (i.e. cutting back on services), all the while gaming the system to barely squeak under the wire before Medicare makes them give back the money.

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2022 Hospital Safety Grades announced at Leapfrog Group’s annual meeting: excellence and the power of transparency

On Tuesday I attended one of the most inspiring events in the annual calendar of health events: the Leapfrog Group’s annual meeting and awards ceremony. I could talk all day about what an important organization this is, because they don’t just do great work, they’re getting results in the world.

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When Patients Design the Care They Want: the Boston Women’s Health Collective

A slide I often use

In August Medical Futurist Bertalan Meskó and I published Patient Design: The Importance of Including Patients in Designing Health Care in JMIR, in the Journal of Medical Internet Research (JMIR). It ties together aspects of both our work. He’s a medical futurist, less than half my age, with a clear vision of how medicine will work in a future unencumbered by today’s limits. For me, an advocate for patient empowerment, it’s rooted in patients having the power to get the care they want. Our views come together in the idea of patients designing the care they want. From our abstract:

… genuinely empowered people living their lives and managing their health according to their own priorities, in partnership and consultation with physicians as needed. 

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The Long COVID Survival Guide: essential new book with first-hand patient reality

I’m burning my way through this book, which was just released last week. It’s a compilation of first-person essays and advice from twenty Long COVID patients and experts. Curated by long-hauler Fiona Lowenstein, The Long COVID Survival Guide strikes me as street-level gut-punch practical. I don’t think any of us – patient, family, clinician or government – can feel we understand this condition without reading these essays.

I was hooked when I discovered, in the first patient story, that hives can be a result of Long COVID … which explains the weird, unexplained hives my wife had 4-6 weeks after COVID. Nothing like some front-line patient reality!

That’s a strong example of a big shift that’s happening in medicine: shifting away from expecting doctors to know everything important, and toward doctors actively partnering with the sick people. And by “partnering” I don’t mean asking patients’ opinions: I mean actually sharing the work, acknowledging the value of patients’ work, and sharing decision making – not just on individual cases but on development of remedies and priorities for research.

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“From #73cents to FHIR”: keynote at the Redox Connect customer conference

Patient voices have been working for decades to achieve access to their medical records, which have always been locked up in the hospital. No more: new rules went into effect on October 6 that mean all your health data must be available for download by apps, online, by end of year.

This so-called “Cures Rule” is part of the continuing work of the 21st Century Cures Act enacted by Congress in 2015. The Act includes many other things to improve development of cures, but for patients a vital new requirement is that health data must now move easily between computers. It’s common sense for everyone in healthcare, and for patients it’s an immense win for justice (fairness): at last we can see about ourselves what the people treating us can see.

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