Search Results for: e book

December 31, 2012 By e-Patient Dave 1 Comment

Reprise: The healthcare waste pit is BIGGER than the fiscal cliff.

For my last post of the year, as word filters out that Washington still can’t fix “the cliff,” I’ll do something rare: repeat something from just a few days ago. This needs to sink in for everyone who wants to fix America’s medical costs:

The “fiscal cliff” is big, but America’s excess medical costs are 30% bigger.
(Not total costs – just the waste that needs to be trimmed.)

As we start 2013, think about that.
Think how much commitment and guidance
it will take to fix it.

Some providers are working really hard to improve effectiveness,
and some insurance companies are too.

Some aren’t.

A lot of people’s income depends
on keeping things the way they are.

During the change, how will we ensure
that families and the best workers in the system are protected
while inefficiencies are pruned?

Here’s this week’s post again, tweaked just a little:

[Read more…]

December 29, 2012 By e-Patient Dave 9 Comments

What “patient centered” means to me: a realization from Holland on the role of the patient in research

patients included badge

I’m sensing a number of things coming together, creating a new view of what’s possible and what’s changing in healthcare. I want to take a moment to present some background, then share the mind-pop that hit me yesterday while writing something. It clarified my shifting view of the role of the patient in medical research – no small subject!

Background: different views of the role of the patient

As regular readers know, patient engagement got a big boost in April 2011, when I was invited to speak at TEDx Maastricht in Holland. My talk there continues to be in the top half of most viewed TED Talks of all time – an enormous boost to any cause.

Well, it’s no accident that it happened there. Organized by my now-friend @LucienEngelen, it was the first in a series of conferences he now calls “the Future of Health,” and for him it’s all about the patients – so much so that it was the first conference I know of where the first speaker announced (a year in advance) was a patient.

That’s an unconventional way to announce a new conference in medicine – and that was two years ago. He’s so patient-centered that a year later he announced he’d no longer attend or even accept speaking invitations to conferences that don’t actively support patient participation. He announced the Patients Included badge you see above. In his TEDxMaastricht talk this year he mentioned his parents’ deaths from cancer and his thoughts about his own odds. Describing the badge, he cites leaders like Gunther Eysenbach, Denise Silber and Larry Chu whose events do include patients.

TEDMED pill warning graphic

His university’s med school mission is “The patient as partner.” This touches, massively, on the TEDMED 2013 Great Challenge, Role of the Patient. TEDMED has tended to think of it in terms of whether patients follow orders: the signature graphic for this challenge (right) is a blow-up of warning labels on a pill bottle! Really, TEDMED?? This signifies the role of the patient?

And in the crowdsourced discussion, question 2 was “Is there a conflict between empowering patients and honoring the expertise and authority of medical professionals?” I have bigger possibilities in mind than whether patients heed warnings and honor authority.:-)

Taking it to the world of research

[Read more…]

December 28, 2012 By e-Patient Dave 3 Comments

The healthcare waste pit is bigger than the fiscal cliff.

Two weeks ago I talked about the magnitude of America’s $750 billion of unnecessary spending (per the Institute of Medicine). 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.

I found another way to comprehend it. Hold onto your hat: $750 billion is bigger than the whole Fiscal Cliff we’re so scared about.

Yes, way bigger than that cliff in the news – the fiscal cliff that’s so big Grover Norquist caved in on his tax pledge, so big it embarrassed Speaker Boehner when he STILL couldn’t rally his troops – that cliff is “only” $560 billion, according to Wikipedia as of today.

I do amateur arithmetic :-) so I was quickly able to calculate that $750 billion is 30% bigger than $560 billion – even without a calculator!:-)

$560 billion + 30% (another $168 billion) = $728 billion.
(Okay, so that’s still shy of the $750b. My point stands.)

Our august leaders Norquist, Boehner and Obama speak of the Fiscal Cliff in desperate terms – but I don’t hear anyone speaking with the same urgency about the healthcare waste pit. But it’s going to hit us all, so you and I – all of us who have a stake in the future of healthcare – ought to be thinking what we’ll do in the coming years as this industry rationalizes to a saner spending level.

The changes will be substantial. As I said in the earlier post, we must detect and protect the good work of the best providers. And above all as fights unfold over the shrinking ocean of money, we must ensure that families who need care are indeed taken care of.
__________

(While we’re at it, recall this 2009 post: I’m sick of hearing Washington talk about savings “over ten years” … how are we supposed to make sensible judgements if a $5 billion saving (a drop in this bucket) is inflated to “$50 billion over ten years”?)

December 3, 2012 By e-Patient Dave 10 Comments

From now on for me, it’s health and care

Health & Care signature

This post became a chapter in my 2013 book Let Patients Help: A Patient Engagement Handbook.

Every year in this season I reflect and renew, emerging in January with new views. This year the first conclusion arrived early: I’m changing a key part of my language. From now on for me it’s not “healthcare,” it’s “health and care.”

Why? Because I’m increasingly seeing that it’s incomplete to look at transforming medicine by just talking about the care part – the part that kicks in when something goes wrong. All of us – patients and providers and insurance and government and industry and everyone – need to be thinking about health, every time we approach a problem with the health care system.

I know I’m not the first to say this, but as a marketing slogans guy (“Let Patients Help,” “gimme my damn data” etc), I’m keenly aware of the power of handy language. Everything I explained above can be said over and over, but it doesn’t fit easily into everyday discourse. “Health and care” is an easy plug-in replacement for the usual “health care.” And that boosts the odds people will use the new wording.

And language defines our thinking.

The implications for patient engagement are clear: it’s not sufficient to get engaged (to get it in gear, to get activated) only when sickness hits. My view from now on is, if you wanna be an e-patient, it starts with holding up your end of the bargain before you get sick.

So for 2013, let’s broaden our scope: the focus of our work should be “health and care.”
__________________

One more thing: I like the word “care” – it’s patient-centered. In my life getting doctored and nursed, I’ve had the experience of being cared for, and I’ve had the experience of just being treated, without care. When I’m in trouble, what I want – what we should all shop and ask for – is great treatment delivered in a caring way.

November 21, 2012 By e-Patient Dave 17 Comments

Tool help please! Evernote? Workflowy? SpringPad?

Springpad

Addition Thanksgiving morning: Your responses in the comments below have already gotten juicy-good and taken this to the next level. Don’t miss ’em. And thanks!

Thanksgiving starts my annual season to reflect and look ahead. It started five years ago – my first blog, “The New Life of Patient Dave,” was born at Thanksgiving, just after my cancer. Each year since then it’s been my time to ask: with all I’ve seen in the past year, people I’ve met, concerns I’ve heard, what’s next? Who will I be in the coming year?

And this year I need help. Tool help, to organize my thoughts. Because there are a lot. So if you’ve faced this too, what have you learned?

The work ahead:

[Read more…]

October 27, 2012 By e-Patient Dave 7 Comments

Who gets to say what’s patient-centered? (Hint: the one who’s IN the center)

This is an adaptation of a message I wrote last night to some friends who are participating this weekend in PCORI’s workshop this weekend. I wish I could be there, but overseas travel was booked for today, months ago. For newcomers I’ll say more at the bottom of this post, but first, my message to the participants.

PCORI’s charter – its very name – is to develop Patient Centered Outcomes. That raises the question:

Who gets to say what’s patient-centered? We should.

The scientific establishment won’t turn on a dime with this one patient weekend, so what COULD we persuade PCORI and the attending scientists about? My view:

To me the core question of the weekend is: Who gets to say what’s patient-centered? I say, it’s the one who’s in the center. Who else could possibly know if things are balanced around them?

So, I suggest: in any patient-centered outcomes project, patients should participate not just in selecting projects or goals/outcomes (from a scientist-generated menu), but in defining the goals, the desired outcomes, even what they’d like researchers to pursue.

This is a maturing of the patient’s role, and a shift in the researcher’s role to one of partnership rather than “doctor knows best.” The maturing seems to parallel how a kid grows up: [Read more…]