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September 5, 2012 By e-Patient Dave 3 Comments

New collaboration: Perry Cohen on ethics in research and patient-centered outcomes

This is the second in a new series on patient participation in guiding medical research.

Perry Cohen, 2012
2012, on the Michael J. Fox Foundation blog
Perry Cohen some years ago
Perry in Africa, 2008

Perry Cohen is a new friend and, I’m thrilled to announce, a new collaborator.

I learned about Perry during my MIT college reunion this June – my classmate Becky Donnellan heard about my work and said “You should meet Perry,” whom she’d met somewhere along the line. On my next trip to DC I met up with him, and indeed we hit it off.

But I’m not thrilled with the reason we need to collaborate: Perry has Parkinson’s Disease, and, as he puts it, “I’m losing my voice.”

That’s no small issue, because for sixteen years Perry has been a powerful and effective voice for the Parkinson’s patient perspective at the National Institutes of Health and the Institute of Medicine. In the progression of his disease, at present we can speak on the phone just fine, but the adrenaline of giving a speech – which he’s good at – is too much. In February he froze up, on stage, for two minutes, and had to be helped off.

So he’s asked me to help with his public speaking.

In this post I’ll introduce Perry, describe how we’ll be collaborating, and close with a specific example that shows how strongly he and I are aligned: an article he co-authored five years ago that blew my mind last week. (I mentioned it in Saturday’s post that began this series.)

[Read more…]

Filed Under: Uncategorized 3 Comments

September 1, 2012 By e-Patient Dave 13 Comments

New series: Understanding and Guiding Medical Research

With my doctor in an exam room
With my primary physician, Dr. Danny Sands, in a BIDMC exam room

Some edits made, and new items added, late the same evening.

I’ve recently learned of some well-intentioned medical research that disturbs me so deeply that I think it’s time to get formal about teaching e-patients and their partners how to detect research that misses its target, even if it’s well intentioned.

Doing this responsibly requires a deep understanding of the purpose of research and its methods. So this is the start of a series in which I’ll lay out what I’ve learned so far, describe the problems and challenges and opportunities that I see, and invite dialog on where I’m wrong and your own experiences as patient or clinician or researcher.

If this succeeds we’ll have a new basis for considering questions of what to do and how to prioritize it, in this era of change in medicine – not just in research but in all of medicine, as we work on reducing our spend. My goal in the series will be to be as clear in my writing as I can, while being as verifiably accurate as I can, given that I’m no PhD or Pulitzer laureate. Critique and correction are welcome.

This first post is an introduction, with background reading.

Context: Patient Engagement

[Read more…]

Filed Under: decision making, Participatory Medicine 13 Comments

August 30, 2012 By e-Patient Dave Leave a Comment

Regina’s “Partnership WITH Patients” conference: donate, attend. (I am.)

Cross-posted from e-patients.net today.  I know my subscribers here have been following the growth of this movement; look at this truly extraordinary development, created by one widow with two kids and no foundation funding, and a bunch of peer supporters.

This is a hint of what social media can enable in giving voice to the disenfranchised – in healthcare and everywhere. You can help – support it in a large or small way. Use our ready-to-click links below.:-)

Yes, “Regina” – you know who I mean.:-) You know someone’s a star in the firmament when they gain first-name status. (Especially in healthcare, where “the other Regina” happens to be Surgeon General!)

As we reported here in June, Regina Holliday has led a band of patient colleagues and professional partners in creating this event, hosted by EMR vendor Cerner, to train and develop patients’ skills as effective advocates and related topics.

This is as grass roots as it gets – please support it,
as I am, personally, with time and cash.

Also, SPM is providing the infrastructure
for tax-free donations to support patient travel.

Summary of links below:

  • Register to attend or sponsor on EventBrite
  • The event’s site: PartnershipWithPatients.com
    • Agenda blog post
  • Donate to the Patient Travel Scholarship Fund on the SPM site
  • Contribute to crowd-funding of conference costs on Medstartr or Health Tech Hatch.

[Read more…]

Filed Under: Events, public speaking Leave a Comment

August 27, 2012 By e-Patient Dave 16 Comments

“Gimme My DaM Data”: the video, the story, the next speech

Did you ever say something that, well, sorta took on a life of its own? This is a pretty good example.

The Video:

The story – short version:

  • [Read more…]

Filed Under: Events, Health data, Participatory Medicine 16 Comments

August 24, 2012 By e-Patient Dave Leave a Comment

“Mind the Gap” on patient engagement: Uck, “What???” and the scapegoat disconnect

Sometimes I don’t know where to post something – on e-patients.net or here. My dividing line is usually: if it’s specifically about participatory medicine, it goes there; if it’s about my views about healthcare in general as someone who goes to a lot of meetings, or specifically about patient engagement, it goes here. This one’s both; I posted it on the e-patient blog, but I want it on this archive too.
________________

Over on Mind The Gap, Steve Wilkins (Twitter) has a poster about patient engagement that annoyed me:-) right out of the box – because although I pretty much like everything he does, the poster starts with what I find to be the ouchiest mental disconnect in all of medicine today. But it quickly follows with the flipside. Here’s a screen grab from its top:

Gut reaction to first quote: What?? “The lack of patient engagement is the Achilles Heel of health care delivery”??  Shades of Health Leaders magazine last October, which said – in an issue on Engaging the Patient no less! –

In our annual Industry Survey, leaders cite patient noncompliance and lack of responsibility as the fifth-greatest driver of healthcare costs … a quarter of respondents pointed to patients as among the top three cost drivers, ahead of health plan overhead, medical devices, pharmaceuticals, and malpractice litigation.

I love it – patient satisfaction scores are generally mediocre, 1 in 70 Medicare admissions ends in accidental death (Inspector General, Nov 2010), and the people who run these chop shops blame costs on their slacker customers. Sounds like scapegoating to me!

[Read more…]

Filed Under: Participatory Medicine, patient engagement Leave a Comment

August 23, 2012 By e-Patient Dave 9 Comments

Neuropathy + chemo brain: Urgent request for expert consult

Lodewijk Bos portraitLodewijk Bos (Twitter @ICMCC), is a good friend in Holland – my wife and I have visited him twice. (My US friends always wonder about the name – Lodewijk (“lodevike”) is the Dutch equivalent of Ludwig.)

Lodewijk has an extraordinary medical history – he theoretically shouldn’t be alive today but he continues to beat all odds. One factor has been his incessant research: an ultra-e-patient, multi-degreed (bio here), author of several books, publisher of the great ICMCC site on health IT (“compunetics,” actually), and editor of the Springer journal Health and Technology, he stops at nothing.

Well, Lodewijk is “Unhappy again,” as he puts it mildly, at the end of his rope again, this time with pain and chemo fog.  I can’t explain it precisely so please see his post, pass this around, and if you find anyone who might be able to help, have them reply on his blog.

A few bits from his post:

On July 2 I had surgery on my left foot … from there on it went wrong, seriously wrong. I was told I should not stand or walk on that foot for at least two day. And I was sent off, on foot. So by the time I arrived at the reception desk 5 floors down … I was given new bandaging and this time someone went to find a wheelchair.

Previous conditions and treatments have left him with neuropathy (nerve damage, causing continuous pain). This new wound wasn’t healing, so days later he contacted a previous wound nurse, who …

… suggested a new kind of bandage Promogran Prisma. And lo and behold, it seems to work. [But] my neuropathy worsened.

The open wound on top of my neuropathy was already hell, but that diminished considerably after a couple of days. However, after applying the new bandage, my foot started hurting much more, but above all, my chemo brain came back in full force. [It can recur years after chemo ends.] When I get out of bed I stumble, having to catch myself not to fall.

After 5 minutes that acute problem disappears (balancing problems remain however), but then the next one appears. My eyes start to spontaneously turn [toward the] nose bridge, as if I were squinting. Which makes concentrating a very complicated business. Combined with the physical balance problems, it leaves me, activity wise, almost paralyzed. Oh, and my tinnitus is worse than it has been for years.

I sincerely hope that the wound heals soon. … walking is no option, the wound is over 1,5 cms large. .. and if you know of any neurologist who might be knowledgeable about this kind of problems, please contact me in the comment field.

Here’s hoping our network of connections can help this time.

Filed Under: e-patient requests 9 Comments

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