I just completed an appearance on NPR’s Talk of the Nation, on the topic of Do-It-Yourself Diagnosis on the Web.

I have only been on radio a few times before, and I have not been on NPR before - it was a great experience to walk down to the studio and see where the magic happens. The conversation itself was fascinating, and I think a great opportunity to demonstrate the transformation of the medical profession that is happening right before our very eyes. Medical groups like the one I am a part of, Group Health Permanente, have really evolved, through the use of the latest technology both by physicians and by patients. I think it’s a better way to take care of our patients. See what you think of the broadcast, and of course I welcome your feedback.

I missed the 60 Day mark due to travel, so this is the 79 day DCVersary. Still a green light, and greater appreciation for this environment by the day. In what other community do people respond to intolerance by staging a hug-in?

There’s a few stray links below about a recent report on RHIOs, and new “innovation” in ISPs accessing the code within Web pages for their customers - a new first.

Links for December 11th through December 12th:

• Wash. Leads Metro Areas in Walkability - people who know me well know that this is a make or break for a city. Another reason to love Washington.
• Underuse of colorectal cancer screening in a cohort of (Fee for Service) medicare beneficiaries - The study excluded managed care enrollees, so it’s really a study of fee for service Medicare, an important asterisk.
• DCist: Hug-In at Rite Aid: ‘It Feels Nice to Hug’ - What a great way to battle intolerance.
• The Shopkeeper Whose Sign Was ‘Open’ - washingtonpost.com - 14th Street Neighborhood leader Noi Chudnoff has passed away
• ZIPskinny demographic information for 20009 - WASHINGTON DC - Demographic Information about my neighborhood
• Dupont Circle Business Networking - Historic Dupont Circle Main Streets - 17th Street is getting a makeover. It looks like Plan B is more elaborate
• The State Of Regional Health Information Organizations: Current Activities And Financing — Adler-Milstein et al., 10.1377/hlthaff.27.1.w60 — Health Affairs - I admit, I have at times gotten in trouble for not being supportive of RHIOs.
• Lauren Weinstein’s Blog: Google Hijacked — Major ISP to Intercept and Modify Web Pages - ISP Content filtering now hits individual Web pages
• What Is Management’s Role in Innovation? ? HBS Working Knowledge - Nice discussion in the comments. I think there is a role, and some of the comments talk about what that role is.

December 4th through December 10th:

• A Wellness Trust to Prioritize Disease Prevention - Brookings Institution -
• Blog Schmog - www.healthleadersmedia.com - Tips on how to blog well, from a blogophobe (self-described)
• Smaller percentage of small firms covering health - Washington Business Journal: - More individuals will be responsible for the cost of their care
• Revolution Health Group buys 2 Web companies - Washington Business Journal: - Revolution now has employees in Seattle….

Please welcome our second physician co-Author on this blog, Joe Kimura, MD, from Harvard Vanguard Medical Associates (HVMA), and Atrius Health, based in Boston, MA. Joe is an internal medicine physician and wears an administrative hat as the Medical Director for Quality Measurement.

We visited Harvard Vanguard Medical Associates last month, and consistent with our goal, wanted to invite a physician leader to continue the conversation here with us. Joe has graciously agreed. Like many of us physicians, Joe is new to the blogging arena, but interested in sharing the breakthroughs and challenges of innovating in patient-centered care.

In talking about building skill in this medium with Joe, I mentioned that he’s a great communicator, and further that he probably didn’t take a patient history perfectly the first time. His response was that he still doesn’t do this perfectly - he said, “I always end up with follow up questions,” which he asks the patient after reviewing their symptoms and the latest medical information about a particular condition. I do the same, which makes me think I need to question what my definition of “perfect” is in this case. Is it more perfect to have all of the answers up front, or to listen carefully and learn more each time? I think that’s a great analogy for health care improvement and using new communication tools to involve our communities in our drive to make our systems better every day.

Please welcome Joe as he continues to practice the art of communication along with Mark, myself, and Josh.

At the conclusion of my visit to California, I was invited to participate in the Northern California Chapter of the Healthcare Information Management Systems Society December event, which focused on Personal Health Records. Talk about great timing. The presentations will be posted to the Northern California HIMSS web site, so rather than post mine here, I’ll encourage readers to find it there when it’s posted in the near future.

The event was held at the historic Sun Microsystems Auditorium, on the Sun Microsystems campus in Santa Clara, California, the heart of Silicon Valley. I haven’t spent much time in Silicon Valley, so for me it’s sort of a mythical place. It was a great experience.

This was a different audience for me, someone who is more accustomed to a health care provider audience, as opposed to an audience made up of technology professionals. What did I learn? I learned that there is a lot more expertise out there working to make PHRs a reality. I spoke with Martin Fisher, Chief Information Officer, from the MedicAlert Foundation about the different approaches that the health care industry and technology industry are taking to make PHRs a reality for consumers, which includes the idea that the technology sector has very good experience being customer centric across industries. The MedicAlert PHR itself is interesting - it’s a PHR that is needed on demand, must be as accurate as the most recent touch with a person’s health or health care, and has less of a dependency on historical information based on the reason for its use.

I also learned about the work that large health plans like Anthem are doing to combine the data they have in claims databases with clinical data, most notably in Ohio at the Kettering Health Network. For my part, I talked about the work Group Health Cooperative and Kaiser Permanente has done to wire the “last mile” between patients and care teams by integrating the PHR with the electronic health record. It was great to see the audience engaged and interested in furthering PHR development health care. It’s getting some real attention, and we will do well to listen and collaborate with technology experts, by demonstrating the impact on patients for everything that we/they do.

The session was coordinated by Jan Oldenburg, who is on the leadership team for Kaiser Permanente’s kp.org. Jan is actively participating in supporting public forums like this, as well as investing time in defining the best PHRs through participation in policy and standards bodies. I’m mentioning this because I think it’s a promising development that organizations who implement this work on behalf of their patients are going beyond their membership to share what they know with the community, and from my perspective, I think they have to - the only way to experience the power of a personal health record is to use one yourself.

Finally, I believe several HIMSS chapters are hosting forums on patient centered health information technology across the nation, including Washington, DC’s chapter, on January 17, 2008. These sessions are open to the public and a good way to meet other professionals working in the field.

PCHIT links for December 6th through December 12th:

• MiVIA - About Us - A PHR for migrant and seasonal farm workers. Impressive. Who says everyone can’t have a PHR?
• Planetree: Providing Patient Centered Care in Healing Environments - As the description says.
• myPHR.com - My Personal Health Record - Helpful resource site put together by AHIMA