Archive for September, 2008

And then there were none? An internist’s reflections — Cleveland Clinic Journal of Medicine

September 24th, 2008 | Popularity: 15%
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And then there were none? An internist’s reflections — Cleveland Clinic Journal of Medicine – Request for commentary on “A Medical Center is Not a Hospital”.

I’ll just put mine here, I’m sure through the magic of Google blog search it will find its way. I think the story is sad and an opportunity. Today’s physicians don’t really have a choice except to do the things we are qualified to do best, which includes bringing the patient experience forward, in every conversation. I haven’t really met anyone who wasn’t interested in the patient experience in any part of health care (or they wouldn’t be here). I have met people who didn’t know what the patient experience was – that’s the opportunity.

I tagged this post with “ROWE” (result-only work environment) because part of the opportunity is to change the health care system so it is less about providing health care (internally focused) and more about getting results for patients. In the process, the people who work in health care may have work lives that are more tied to getting results than in being in a certain place at a certain time, so they can get results for themselves and their families, too.

I’ll stop there and see what other people think.

A medical center is not a hospital — Cleveland Clinic Journal of Medicine

September 24th, 2008 | Popularity: 19%
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e-patients: Safety Net Populations

September 19th, 2008 | Popularity: 31%
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e-patients: Safety Net Populations

The nice thing about the blogosphere is that when you get behind in your blogging, someone else will help you out. Thanks to Susannah Fox for writing about her experience with us in Oakland, California, around the sharing of Pew Research Data with safety net health care organizations.

The comments on the post are especially heartening, in that they support that involving the audience in the presentation of information is meaningful. In this case, they presented just as much information back, which is as it should be.

If I can have one claim to fame in the convening world, besides audience involvement, it is that internet access, checking e-mail, using the Web is allowed at the discretion of attendees. At the last two meetings where I suggested this, people seemed a little caught off guard that this is okay. I want to change that. Just as in the Results-Only Work Environment, in the Results-Only Meeting Environment, respect for people deciding what is most important to them creates the pressure I like, that I/we need to be more interesting than an e-mail inbox.

Photo Friday: Healthcare Business Should Be Like Frozen Yogurt

September 19th, 2008 | Popularity: 12%
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TangySweet

This week’s photograph comes from one of the hottest spots in most cities these days, the frozen yogurt shop. They’re popping up everywhere. As I ordered my green-tea mini with white chocolate chips, strawberries, and pineapple, I asked if this particular store was associated with the other hotspot just a few blocks away in lovely Dupont Circle, and the answer impressed me so much I tweeted it on the spot.

What if the mental model in health care was “co-investment,” just like in yogurt competition? It would go something like this – “we discovered a new workflow/process/patient safety issue in our care delivery. We’d like our peers/competitors to co-invest in it with us to make it even better/make it not happen again.” In this situation, the winners are the ones who can innovate and adapt others’ ideas as quickly as possible, not the ones who have the best firewalls.

Think about it what this would do for health care. It definitely makes for a tastier cup of 25-calories-per-ounce over time.

ConsumerReports.org – Self-test kits: Ratings, How to choose : The Good and Not So Good

September 18th, 2008 | Popularity: 26%
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  • ConsumerReports.org – Self-test kits: Ratings, How to choose – The Good and Not So Good about this reportGOOD: Consumer Reports publishes an article looking at the accuracy of blood pressure monitors, testing them against medical technicians using a mercury sphygmomanometer. Also, nice quote from an MD representing the American Heart Association about the empowering effect of self-monitoring. NOT SO GOOD: A vague recommendation that "patients home monitor" – they did not cite the AHA recommendations about frequency and duration (just twice a day, for 7 days at a time, don’t bring the monitor to work, don’t do it more than twice per day), which may lead to excess or inaccurate monitoring of the condition. I think this is reflective of the fact that the medical profession still has not bought into the value of self-monitoring, and the industry hasn’t bought into reimbursing for it. In the future, reimbursement would be in the form of clinician time to assess and manage conditions, rather than patient time to come into the office, where the readings will be less predictive of a patient’s condition anyway. It could be as simple as a slight change to a pre-existing CPT code for Ambulatory BP Monitoring, which almost no one uses, because 24-hour around the clock blood pressure monitoring is a procedure that has not been state of the art for a long time.

IBM Health Care Executives Receive Highest Honor from American Academy of Family Physician — Media Center — American Academy of Family Physicians

September 18th, 2008 | Popularity: 16%
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IBM Health Care Executives Receive Highest Honor from American Academy of Family Physician — Media Center — American Academy of Family Physicians

From the AAFP press release:

“Comprehensive, continuous, patient-centered, personal and holistic primary care which is based on strong relationships between patients and their physician — this is foundational to good health. Practice and payment reform are the prescriptions for achieving it,” Grundy recently told health care blogger, Ted Eytan, M.D.

I am happy to be told anything, anytime by Paul Grundy – his energy and interest in doing the right things for patients everywhere make him a fine addition to the community of America’s Family Physicians. Welcome, Paul!

Revolution Health: Heralding the Demise of "Health 2.0"? | Trusted.MD Network

September 18th, 2008 | Popularity: 30%
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Revolution Health: Heralding the Demise of “Health 2.0″? | Trusted.MD Network

Is Health 2.0 in demise or not?

This is an opinion column followed by a lively discussion, including a comment from Matthew Holt.

My comment: I don’t think it is .

Why? Because Health 2.0 is not a company. It’s not a person. It’s a different way of thinking about health, and it’s a way that’s being thought of by many people who are disappointed in Health 1.0. As Susannah Fox said, “When over 80 % of people are online, the horse is out of the barn.”

People are interested in Health 2.0 (me included) because they want patients to win, where they are not winning in Health 1.0 (look at the data around hypertension management).

The challenge of commentary that is of the demise-prediction variety in the case of the Internet/Web2.0/Health2.0 is that it reads as anti-patient, and I don’t think our profession is anti-patient or wants to be perceived as anti-patient.

As I have mentioned previously, I think it’s a better place for us to listen to what people are actually doing, do it with them, and help them leverage it for their health. Companies will come and go; people’s desire to achieve their life goals will be a constant.

First Responders Fail To Check Cell Phones for Medical Information – iHealthBeat

September 18th, 2008 | Popularity: 8%
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Chronic Disease Care Conference – Better Ideas in Action

September 17th, 2008 | Popularity: 13%
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Health Affairs Blog – Medical Homes — And Medical ‘Home Runs’?

September 17th, 2008 | Popularity: 8%
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