e-Patient Dave

Power to the Patient!

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What should patient engagement be? An open-ended survey

AIR's model of the dimensions of engagement from Health Affairs, Feb 2013
AIR’s model of the dimensions of engagement from Health Affairs, Feb 2013. Click to visit their site’s description.

Survey is open through Friday, Dec. 20, 2013.

I’m playing a [modestly paid] role in a project produced by A.I.R., the American Institutes for Research, a Washington think-tank I crossed paths with last year through my work with Aligning Forces for Quality.  Boy do we like each other!  Very much think-alikes. Truthfully, it’s hard to figure out how to incorporate “just a plain old patient” voice into their work (“What do you pay for a thingie who has no master’s or PhD???”) but these guys are working on it, and I love it so I’m playing along.

A.I.R.’s Center for Patient & Consumer Engagement is producing a think-tanky white paper on where patient engagement should go, and, brilliantly, THEY WANT TO KNOW OUR OPINION ON IT! Of all things!  So this is YOUR chance, your opportunity, you AND your friends.  There’s no limit on how many responses they’ll accept. (The graphic at right is their concept a year ago of the dimensions of engaging patients, published last February in their article in the Health Affairs issue on patient engagement.)

To be clear: this survey is your chance to speak into a document that a lot of planners will read.  It’s a simple 5-question survey, really open-ended, looking for YOUR experiences about what feels right or feels wrong, and what medicine can learn from it. The survey has no underlying academic assumptions about what patient engagement should be. They really want to know how we (you) see the issue.

Here’s a link to the survey itself – five questions, each with an open-ended text box. I’ll summarize them, because frankly I think what they’re after isn’t always clear in the survey itself. :-)
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Interview with Dr. Brian Goldman @NightShiftMD last May

Being interviewed by Brian Goldman MDLast May I spoke at Kingston General Hospital in Kingston, Ontario, a couple of hours northeast of Toronto. They’re a remarkable hospital – five years ago they were a disaster, and under the leadership of CEO Leslee Thompson and her team, they’ve become spectacular. One key example: their staffers’ hand hygiene achievement is now at 96%! (Most hospitals are at 60% or lower, which is the primary cause of hospital acquired infections ending in death.)

A key to KGH’s turnaround was to actively partner with patients they’d previously wronged, and many more patients since; patients are now part of every decision team, even hiring of doctors. As you might imagine, working with them on this event was one of the highlights of my year.

A major treat was meeting two bright stars of Canadian health media, journalist André Picard @PicardOnHealth and Dr. Brian Goldman @NightShiftMD, author of The Night Shift: Real Life in the Heart of the ER and host of the CBC Radio program White Coat, Black Art.

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Speaker Academy #15: The contract

Addition October 30, 2014: in comments a meaty discussion has started on a subject that’s related but different – NDA’s (Non-Disclosure Agreements). They rarely arise in speaking engagements but they can often be part of “the business of patient engagement.” Have a look if you’re interested.

e-Patient Dave contract template 2013This is the latest in the Speaker Academy series, which started here. The series is addressed to patients and advocates who basically know how to give a talk but want to make a business out of it. I’ll try to be clear to all readers, but parts may assume you’ve read earlier entries.

I’m at the Institute for Healthcare Improvement’s 25th annual forum in Orlando, participating in a day of patient speaker training. In side conversations one thing that came up is the business relationship: getting paid. And that starts with the contract.

Do you need a contract?

Contracts weren’t important for me when I had few engagements and little pay. But when things got busy I needed structure. The contract I use (at right) provides:

  • A clear record of logistical details: where, when, arrival & departure, how you can list it, etc.
  • A clear record of finances: fee, expense reimbursement, and down payment
  • Who’s expected to be in the audience. (Today one speaker told of a case where she was sure an audience would be nurses, and found out at the last minute it was patient advisors!)

And of course in the rare case where a relationship goes sour, the contract records who owes what to whom. It’s not that you’ll end up in court – to the contrary, it keeps you out of court, because the rules are already in writing.

I also added sections for things that kept popping up as problems: [Read more…]

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My best friend has died.

Levy family visit 2007
Dorron & family during their visit when I was sick

The smartest man I’ve ever worked with, my best friend, died unexpectedly this week. I’m en route to Tel Aviv for his funeral. He’d been having significant swings in his health, and this time, just as it seemed there was a breakthrough, time ran out.

His name was Dorron Levy, and my daughter describes him to friends as the Israeli version of me. He taught me how to think about complex problems. He taught me to be very picky about coffee. His family and I fell in love. And he taught me how to construct a speech in a way that it opens a big question in an audience’s mind and then fills it, leaving them with a new view of how the world works.

He loved books, he loved solving impossible problems, he loved learning, and he loved teaching. (He once said the biggest compliment was to hear “You really taught me something.”) He loved digging down into the deep underlying causes. And when that led to solving an impossible problem, the glee on his face was a wonder to see. And as a dual citizen – born in Denver to Israeli parents – he was extremely astute about differences in culture.

I worked with Dorron at Indigo America in the 1990s, [Read more…]

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Engage With Grace: annual Thanksgiving blog rally on responsibility about end of life

Once again this year, Alexandra Drane of Eliza Corp., and friends, have coordinated the Engage With Grace blog rally, in which scores of healthcare bloggers devote their site, for a day or more, to this important topic.

They chose this time of family get-togethers to encourage conversations about our end of life choices. It may seem odd, but what other opportunities do we have to discuss, in quiet moments, this most intimate of subjects?

In case you haven’t seen it, here’s Alex’s talk at TEDMED 2010 in San Diego, with the moving story of her sister-in-law’s death – and how very, very important it was to her daughter (to this day) that her mother’s wishes were honored.

Be sure your wishes are known. Even if you don’t expect your words to matter for a long, long time, say them now.

Here’s “The One Slide” with the five questions Engage With Grace asks us to answer. In fact, you can go to their site and register your wishes.

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The Garfield Project: learning from the death of our 20th President

James Garfield (from WhiteHouse.gov)
James Garfield (source: WhiteHouse.gov)

One of my most potent, visionary, and interesting clients this year was back in February – St. Luke’s Health System in Boise. (Did you know Boise is pronounced Boissy, not Boizey?)

I could say a lot about the time I spent working with them. Their CEO David Pate had heard me speak a year earlier at a small CEO roundtable, and subscribed to this blog. When I posted my RFP for my skin cancer, he wrote and said “I’ve got a proposition. Come do your talk as Grand Rounds, and we’ll do the surgery for free.” I said “Thanks but no thanks – but since you asked…” and we started a discussion that led to a multi-day engagement, working with their leadership team and giving a keynote to a big leadership meeting last winter.

I subscribed to his blog too, and in today’s feed is a fascinating story: Learning from the 20th President. That president was Garfield, who died 132 years ago. He was shot, but the bullet didn’t kill him – an infection did, months later, almost certainly caused by the stream of doctors who stuck their unwashed fingers and tools in him to try to find the bullet.

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