Slides, Script, References, Photos, from my #ONCmeeting Ignite Talk – Acceleration and Tipping points – Consumer E-Health

Here’s the script, the slides, and the reference used in my presentation today at the 2011 ONC Annual Meeting, in Washington, DC. This format is definitely challenging, still it’s a great experience to create a message using this format, and really fun to do it for the first time with three other people.

Most of the photographs in the presentation were taken by myself, I’ve included links to them in the list below. You are welcome to use any per Flickr community guidelines.

Enjoy, let me know if there are any questions, comments and feedback welcome.

And now I get to say, Ignite – check that box 🙂 .

Hi. I’m Ted. I entered medical school hoping to be a family practitioner, I left medical school hoping to be one, too (and I became one). However, when I realized that primary care was hallway of blinking lights, my vision for medicine was changed forever.

I didn’t understand why this was the only way to listen in primary care, going from room to room, providing the same information that only I had, again and again, to people who physically came in to be seen.

Where did the hallway come from? It came from where health care used to be – where the only way to listen was in person, occasionally on the telephone.

A colleague recently told me that her first experience with a personal health record made everything else feel antiquated/past life. Here’s what she was talking about.

In 1999, patients were interrupted by physicians 23 seconds after they began speaking. This was up from 18 seconds in 1984. 72 % of the time, they never got to finish their opening statements.

Thanks to health information technology, we can listen better. This is what you’ll find at a Kaiser Permanente medical office, like this one in Portland – options to be heard. Because of the interest in listening better, adoption is huge, hockey-stick like.

3.7 million patients are now registered to use our personal health record, 61% of all eligible members, 50% of medicare members, are logged on, and 27% logged on more than 11 times in the last 6 months.

Same goes for caregivers, because we realized through technology that the patient in front of us was not the only person that needed information. It’s the child/parent/loved one of the patient, too.

You shouldn’t think of this as one big personal health record – think of this of multiple connections to individual practices in a system.

And this is what listening looks like in 2011. Add another million e-mails send to physicians and another 2 million test results viewed online by members to those numbers to be accurate through Q3 2011. Also 4.4 million after visit summaries.

The cool thing is, I don’t have to tell you why this is important, your patients will. They’ll say things like “health care used to happen in a hospital”, and “I’d be up a creek” without the connectivity my caregivers have to my health care.

Oh, and the care is better. Here’s just one example. Blood pressure control in the era of the electronic health record was already showing huge gains, way beyond what was thought possible.

When we examined the impact of patient-physician e-mail, the control was significantly better than that. The same is true for diabetic and lipid control. Not bad!

Notice that e-mail makes everything BETTER, so regardless of your abilities, you can improve your performance with the connectivity to patient and family.

Let’s talk about the threat of information overload. It’s real. You will have to pay attention to your workflow and you can make it work. Again, the goal is to listen better, because the threat of not listening is even greater.

Even in organizations with advanced electronic health records, it is still critical for patients and families to be involved. This is not just a burden, it can be devastating. This PIE should be whole, which equals an accurate, safe, health system.

So what will happen next, after electronic health records and personal health records are the norm, rather than exception? Let me float some ideas…let’s start with the practice of medicine. Family physicians will be able to lead teams with more tools and time to listen to patients.

They will return to practicing the full spectrum of family medicine, in medical homes, supported by great specialists, all with more time, and more flexibility in their work schedules.

When the front door to your electronic health record is a computer screen or a cell phone screen, you will start listening to what your patients are doing when they are not in the medical office, and it will change the way we think about our roles in the medical system and their lives.

We’ll see signs like this, because we’ll invite patients to participate outside of the exam room, in patient advisory councils, and we’ll listen to them as strategic partners in the design of a better health system that will improve faster.

We’ll build a health care system that blends into the environment better, with more efficient buildings and less parking lots. Parking lots are the most toxic structure you can build in terms of environmental impact. US Health care activities account for 8% of total Greenhouse Gas emissions, by the way.

And then, health care will be healthier, and your patients will be too, because you’ll contribute to total health. Total Health includes mind, body, spirit, individual, family, community, society. The health care system will function as highly here as it does in the hospital.

And that’s what you’ll get from being able to listen better. Thank you.

Links to facts/data/photographs:


Bravo Ted. Good points, very pleasingly presented. I see two advantages to email (not instead of in-person, but as a supplement). 1. It’s remote (no travel and time lost) and 2. it’s asynchronous (can be sent anytime, read and responded to anytime). Both add to convenience and accessibility, but of course, you lose the nuances of tone of voice, body language, etc. What do you think about something inbetween like Skype or GooglePlus-like videoconferencing, which would be remote, but synchronous? I expect patients would love it, but it would be intrusive on the physician’s time and would have to be scheduled. What would clinicians think?

Hi David,

Thank you for taking a look and for your comment!

I think the experience of unleashing listening in medicine will only pave the way for more innovative ways to listen. Any technology could be considered “intrusive” if not designed and implemented well, and any technology could be considered “breakthrough” if it brings people together in a convenient way that makes them healthier. The question then is just to find the right way to deliver what people want, that’s where hopefully you come in :),


Ted Eytan, MD