e-Patient Dave

Toward a New Science of Patient Engagement

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How to improve healthcare faster: a TEDMED minute

This past week I was thrilled to attend TEDMED, the medical offshoot of the famous TED conferences. (TED = Technology, Entertainment, Design.) I was invited to be one of the analysts sponsored by the Robert Wood Johnson Foundation (RWJF) Pioneer Portfolio, my kinda people: “The Pioneer Portfolio is powering ideas to transform health. We accelerate the trajectory of innovation … supporting exploration and helping great ideas to gain momentum. Pioneer focuses on the future, seeking breakthroughs with the potential to generate significant health and social impact.” Huzzah!

The Pioneer Portfolio funded the creation of the e-Patient White Paper, which blew my mind almost three years ago and set me on this path. (That paper’s at top right of www.e-patients.net.)

At TEDMED RWJF asked the analysts (and anyone else!) to record brief, informal videos on how to improve healthcare fast.  Here’s mine:

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When a patient speaks to patients

As I build my new career in healthcare, speaker fees are my main income. Here’s one I did for free.

Usually when I speak, one of the first things I have to say is “Trust me, your time will come. ‘Patient’ is not a third-person word.” Well, I got to skip that part in June when I spoke to a bunch of people who already have my disease. And boy did we surpass the normal subject matter.

The event was the third annual Kidney Cancer Symposium sponsored by the DF/HCC, aka the Dana Farber / Harvard Cancer Center. That mouthful includes my hospital, Beth Israel Deaconess. Speakers included my doctors, surgeon Andrew Wagner and oncologist David McDermott. (With MDs and Mxxx’s up the wazoo; I love those guys but I gave up on keeping tabs on their credentials. To me they just saved my life.)

They invited me to speak about being an e-patient. Couldn’t turn THAT one down. 35 minutes:

Immense thanks to them for making this event FREE (including lunch) to all patients, and offering the video for free distribution to all who weren’t there.

They say the videos of other talks will be available on their site shortly – with full credentials for the doctors, probably. :–) Thanks to them for letting me have it first!

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Loving the reponse to “Laugh, Sing, and Eat Like a Pig”

Front cover Full title: “Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer (and what healthcare can learn from it)

Thanks for the incredible response!

What’s the title about??

It’s the approach I chose to take to the news that I had a lethal cancer – a summary of the advice I got in the first few weeks after diagnosis, before I even started my journal:

  • “Laugh” is for the healing power of laughter, as famously discussed by Saturday Review editor Norman Cousins in his book Anatomy of an Illness as Perceived by the Patient
  • “Sing” is the advice my doctor gave. I had asked if I should drop out of my much-loved championship chorus to save energy, but he said, “You don’t want to stop doing life activities that you love – it sends the wrong message.” Wow. So, okay, laugh and sing! Not bad. (More on what “Sing” meant to me in this post.)
  • “Eat like a pig” refers to the diet the hospital sent me, to increase my caloric intake, to combat weight loss and prepare for the battle ahead.

In my online community I told people “If I ever write a book about this, that’s what I’ll call it.” And here we are.

Admittedly, that’s not a conventional approach to a deadly disease. But that’s the point. And the whole story’s true.

Why a book with this message?

4,000 people a day (in the US alone) discover they have cancer, and face that moment of “What on earth do I do NOW??” I know that feeling. Some look for what to do next; others don’t even think they can do anything — they just think they’re screwed and go into depression. This book is about hope, getting it in gear, and going “e.” (E-patients are “empowered, engaged, equipped, enabled, and educated.”)

What’s the vision?

I’m committed to a world where healthcare works better – and not just for patients but for the people whose work is to deliver care. I agree with the words of Warner Slack MD, who said patients are “the most under-utilized resource” in health IT, and I think it applies to all of healthcare.

Healthcare today has unprecedented challenges. Let patients help (which a year later became my TED Talk, then my next major book).

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“The Quantified Patient”: my talk at “Quantified Self” show&tell, December 2009

Cross-posted from e-patients.net

The Quantified Self (aka “QS”) is an informal San Francisco based group of people who are tracking one thing or another about their lives. (Could it exist anywhere else??) They have occasional “Show&Tell” meet-ups, with elbow-rubbing and a series of quick talks, 10-15 minutes each.

A few weeks ago I was in town for a talk at the northern California chapter of HIMSS on personal health records. Matthew Holt of Health 2.0 and The Health Care Blog told me QS was meeting that Monday, at the headquarters of Wired magazine.

I registered, and at the end it asked “You wanna present?” I never say no to that, though I didn’t know what I’d talk about.

Turns out host Gary Isaac Wolf was really interested in the little spreadsheet where I’d tracked my tumor sizes as my treatment progressed. :–) So in the context of “quantified self,” my topic became “the quantified patient.”

This is an informal production – audio from a camcorder (no mic) blended with my slides and a few other images. It was fun: a responsive, engaged audience. Thanks to the QS gang for the opportunity.

Related notes –

  • QS is a project of Wired‘s Gary Isaac Wolf (Associate Editor) and Kevin Kelly (Founding Executive Editor). “KK,” as he’s known, is also on the advisory board of our Journal of Participatory Medicine.
  • KK’s videos on Vimeo include several others from that night. (Arg: the room was so full the camera had to shoot the speakers from the side – no slides!)
  • Among the other presenters that night:
    • Spectacular e-patient and #getupandmove entrepreneur Jen McCabe
    • Spectacular human and entrepreneur Esther Dyson, also on JoPM’s advisory board.

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Making Healthcare Better through Participatory Medicine

I was humbled and honored today that my primary physician Dr. Danny Sands and I are on this year’s list of 20 People Who Make Healthcare Better, an annual feature of HealthLeaders magazine.

Photo courtesy of Beth Israel Deaconess Medical Center
With Dr. Sands in an examining room at Beth Israel Deaconess Medical Center (photo courtesy of BIDMC)

This is validation that patient engagement – participatory medicine – is an idea whose time has come.

I’m a spokesman for the movement (and yes it’s now a movement), but I’ve been at it less than two years. I want to acknowledge some of the pioneers who paved the way.

First, of course, is Dr. Sands. As the article says, “Sands is a huge advocate of using technology to improve the patient experience.” And he’s good at it: I know firsthand that he provides clear, empowering, gentle yet firm guidance.

Second is the terrific group of pioneers, analysts and visionaries at e-patients.net, who authored “E-Patients: How They Can Help Us Heal Healthcare,” aka the e-patient white paper. The one with the greatest personal impact on my case was of course Gilles Frydman, founder of ACOR.org, the patient network where I found the best information on the internet about my disease.

Less widely discussed are the clinicians who managed my case: oncologist Dr. David McDermott, surgeon/urologist Dr. Andrew Wagner, orthopedist Dr. Megan Anderson, and nurse practitioners and nurses (alphabetically) Kendra Bradley, Gretchen Chambers, Meghan French, MeeYoung Lee and Virginia Seery. Every last one of them fully supported my avid desire to participate.

The article cites one example of how Dr. McDermott encouraged my questions. When your life is on the line, that’s a wonderful thing – and since he’s at the top of his craft worldwide, it proves that brilliance is compatible with empowerment.

Finally, there’s Paul Levy, CEO of the medical center. When I approached Paul in 2003 looking for a doctor, he said “You’ll probably like this guy” and referred me to Dr. Sands. I guess he was right. (Paul was in the “20” in 2007.)
DannyCard3
I want to set the record straight on one point. These days Dr. Sands is sometimes introduced at conferences as “e-Patient Dave’s doctor.” People forget (as we used to tell Mom), “He started it.” For instance, although some docs today still don’t do email, at right is the “back of a business card” set of guidelines Danny published – ten years ago.

(If your doc doesn’t do email, be empowered: click to enlarge, print, and take it in. The voice of the patient (you!) can change things.)

Participate – in our Journal

This year e-patients.net incorporated as the Society for Participatory Medicine, whose principal activity has been the new Journal of Participatory Medicine, which launched in October. The editors are soliciting articles and essays. If you’ve been doing participatory things, you can fortify the industry’s knowledge by sharing your experiences. Please write to editors at jopm dot org.

Thanks to the pioneers

The lead of the HealthLeaders article captures what inspires me about this work:

The very essence of healthcare is to make a difference for good. At its core, this is an industry focused on making life better for people. That simplicity of mission establishes a shared grounding for the millions who work daily to deliver the best healthcare they can.

It’s a true privilege to be part of this group. Thanks to all – and congratulations to all the others on the list.
_______________________

Update December 18:

Here’s an informal, off-the-cuff conversation Dr. Sands and I recorded just after we delivered the Medical Grand Rounds interview on December 3 at Beth Israel Deaconess Medical Center.