Archive for November 5th, 2007

Blogs and/or Peer Review, how will they co-exist?

November 5th, 2007 | Popularity: 14%
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Of late there has been discussion in the role of blogs in communication, both for relaying information, and stimulating action. Much of the discussion in my environment about this is generated by the fact that I am blogging most of what I am doing, and intentionally so (such is the life of a change agent/leader type).

On the micro level, it has been interesting and great to explain to the organizations and people that I meet that I am blogging what I see/do (with the exception of any personally identifiable information of patients). The reactions are varied, as one might expect and there isn’t really a lot of time to explain everything there is to about Web 2.0 because people are busy just doing what they do.

On a macro level, I have a prepared talk that I have given about blogs and their role in change management / communication. I think they have a huge one now and into the future, especially in a learning organization.

At the same time, I think about the value of peer review in describing what I’m doing. What is it?

When I look at the communication revolution that is happening with Web 2.0, I’m unsure that MEDLINE citations are the most important standard for creating portable knowledge in health care, especially in the areas I am working with, Informatics and process management and improvement (LEAN and Toyota Management System).

As it was pointed out to me last week by our advisors, the Medical Home movement came from a PDF on a Web site, and I would call that piece pretty transformative. A lot of the data I have used in patient centered health information technology has been very robustly compiled by the Pew Internet & American Life Project, also very transformative.
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Patient-Centered Care: What Does it Take?

November 5th, 2007 | Popularity: 13%
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Speaking of “what am I observing for,” Holly Potter from Kaiser Permanente let me know about this excellent report from the Commonwealth Fund. It’s a nice review of the history and components of Patient-Centered Care, accompanied with data from interviews of key experts in the field.

For this project, it helps add a little structure to our observations, because there are discrete things we can look for. The report takes the reader through two example organizations that have these attributes. The checklist it cites is:

  1. Leadership
  2. A strategic vision, clearly communicated (“from the boardroom to the bedside”, or I might say, “from the boardroom to the exam room”)
  3. Involvement of patients and families at multiple levels
  4. Care for the caregivers through a supportive work environment
  5. Systematic measurement and feedback
  6. Quality of the physical environment
  7. Supportive technology

These concepts, especially #7, are right up PCHIT’s alley, as are others that were emphasized by our Advisory Group last week. We have to be careful that this initiative is mostly about #7, at the same time, #7 is a tool to serve the other 6 items.

In contrast to the way data was acquired about organizations, in interviews, I am going to the exam room myself (“Genchi Genbutsu“) to understand each organization’s experience. I think by definition, an organization that is interested in the answer to these questions probably has answered them well already.

The “Adjust” from the Advisory Group: Part I

November 5th, 2007 | Popularity: 14%
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Eytan-Pchit-Advisory Group

PCHIT Advisory Group – Slides

This post is first in a series will summarize our status and input from our Advisory Group (Blogs are about a little information at a time). Both the Group and this audience are welcome to comment. Our goal is to make any adjustments necessary, now, and continually improve our process as we do this.

The summary comes in the form of an “A3″ document and a short set of slides. The slides are published here.

A reminder that an A3 document really just outlines a story. It’s probably best for this medium for me to discuss the work of each Advisory Group member (with the exception of Patricia Flatley Brennan, who could not be with us this first time) and the impact on adjusting our work.

To also keep this manageable, I’ll do it over the course of the week, one each day.

Michael Barr, MD, MBA, FACP: Michael, as Vice President of Practice Advisory and Improvement for the American College of Physicians, is leading the Medical Home work of the College. This includes establishing the “systemness” of the Medical Home, as well as understanding the economics of the Medical Home. He is working with payers to establish the benefit to patients and ability of Medical Home to address self-management goals. As currently devised, this model is most effective in practices where there are longitudinal relationships, such as primary care, but also in specialty care in certain circumstances. Several demonstration projects are set to begin in 2008. The College’s Center for Practice Innovation has been working with small practices to transform them, in line with Medical Home principles. The ACP is heavily involved in technology issues, at the level of some delivery systems. Finally, we are alerted to the publication of a white paper in the Annals of Internal Medicine on payment methodologies.

Adjustment: The impact of Medical Home discussions locally and nationally is very clear, and observations in PCHIT should be connected to Medical Home principles. Ted Eytan is presenting at the CPI conference in Washington, DC, on November 17 and will be spending time with CPI staff and practices as part of this involvement. The ACP white paper will be reviewed by us as well for implications for PCHIT.

Bookmarks for October 25th through November 4th

November 5th, 2007 | Popularity: 16%
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October 25th through November 4th: