e-Patient Dave

October 1, 2013 By e-Patient Dave 12 Comments

Hey Watson! Let patients help!

Katherine Hobson has a new article about IBM Watson in the US News and World Report Best Hospitals issue:

The IBM Wiz Kid’s Work on Cancer
Watson’s foray into oncology is only the first baby step toward applying “big data” to thorny medical problems.

As this giant Jeopardy-winning supercomputer continues its venture into medicine, it’s fascinating to watch, but I continue to scream “WAKE UP!!” to anyone at IBM who’ll listen, because I think there’s a vast opportunity that’s not being pursued. And we need it! (I’m quoted at the end of the article, opining on this.)

What they’re doing

I love that they’re exposing Watson to gobs and gobs of previous cases, as the article describes, so it can sniff for patterns. If there’s one thing a well programmed computer can do, it’s sniff for familiar patterns.

And I love that they’re using it to suggest diagnoses and treatments to the doctor, not make diagnoses or recommendations. (I’ve long said that I doubted IBM’s lawyers would want to be anywhere near liability for a wrong diagnosis and its consequences!) An “information-suck-and-sort” machine should do just that.

(At least for today. Who knows what we’ll think in a few years; I’m not in a position to predict.)

What they’re not doing (yet)

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September 26, 2013 By e-Patient Dave 2 Comments

“Typesetters have proofreaders. Doctors don’t.” Let Patients Help!

iHealthBeat screen capture (click to visit the article) — Click to visit the article

Please see the “call to action” at bottom of this post: if you have a story of patients improving the chart – or a provider preventing it – put it in a comment on iHealthBeat.
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I have a new essay in iHealthbeat’s “Perspective” feature: Patient Participation: Let Patients Help With Medical Record Quality, Completeness.

This was a pretty great invitation. As it says at the bottom of the site, “iHealthBeat is published daily for the California HealthCare Foundation by The Advisory Board Company.” CHCF (the foundation) has done a ton of great work over the years at understanding the practical realities of medicine as it works out for families and communities, and The Advisory Board Company is a respected, high profile company that advises health leaders of all sorts. So when Managing Editor Kate Ackerman wrote to me – six months ago! – inviting an essay, I was thrilled:

I wanted to see if you’d be interested in writing a Perspective article for iHealthBeat on the importance of patient engagement in health IT efforts. Here’s a link to our Perspectives archives so you can get a better sense of the feature: http://www.ihealthbeat.org/perspectives-archive.aspx

One never knows why the timing works out the way it is, but it didn’t work then, and when she asked again recently, it did. Of course, back then the angle wasn’t clear to me, and this time it was: Typesetters have proofreaders; clinicians don’t. Let patients help!

If you want to support the movement, see if there’s something you could add an anecdote in the comments on that post – a story you know, first-hand or close, where patient and family engagement in the medical record prevented a disaster. Or helped in some smaller way.

September 25, 2013 By e-Patient Dave 3 Comments

My talk at NCSBN (National Council of State Boards of Nursing)

In August I gave one of my most successful speeches ever, at the annual meeting of the National Council of State Boards of Nursing (ncsbn.org). These are the people who do board certification of nurses and, when necessary, look into cases where discipline may be needed. In short, these are people for whom quality makes all the difference in the world; it is their work.

I was inspired and thrilled to be invited to speak to them. As always, we had a lengthy call to plan the focus and objectives of this talk. Here’s the video – I’m even more thrilled that they hired such a great video company! Multiple cameras, high quality slide rendering, and terrific editing. Thank you!

The video doesn’t show it, but the audience gave a standing ovation. It’s a wonderful feeling to connect with people at that level.

If you can’t see the video, click here.

Evaluations:

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September 23, 2013 By e-Patient Dave 6 Comments

14 minute “Show Opener” speech at the Consumer Health IT Summit last week

Who says the gummint can’t move fast?? Last Monday morning I gave the opening talk in Washington for the Consumer Health IT Summit, and holy cow, the video’s already been edited and is live on YouTube!

If you can’t see the video below, click the screen capture at right to view it on YouTube.

(Caution – them same gummint people live with policies that didn’t allow me to plug in my computer; we had to use theirs, which of course hasn’t been upgraded from PowerPoint 2007 yet. The contractors assured me my slides would work fine, and after a half hour of emergency surgery they mostly did, except the one where the text came out black and the slides that kept changing spontaneously – always fun for a speaker to deal with. But the message got across!)

This is really important, folks! Speak up! Get involved!

There are rules and laws and regulations that say you DO get to access your data, and it’s a Federal civil rights violation for a provider to tell you no. And it’s really good that our data will get liberated, because that means innovators can create software and gadgets to do fancy and useful things with your data. And your kids’ data. And your elders’, and your friends’.

Educate yourself – “free your mind,” as we said in the Sixties. The new era is coming – let patients help! And to do that, you gotta have copies of what your doctors see. Get involved.

September 18, 2013 By e-Patient Dave 4 Comments

How not to be patient-centered or customer-centered

Room 313 signs at my hotel — (This photo is explained at bottom)

This is off topic (a business traveler issue) except that there are strong parallels with the important trend of wanting to make medicine more patient-centered. In my speeches I often say this isn’t very different from what other industries do – look at things from the customer’s point of view.

(In medicine a year ago this was announced (appropriately) as a big new insight by the Institute of Medicine – “a learning healthcare system is anchored on patient needs and perspectives.”)

I used to think that in the future of elder housing, Marriott might be a really good vendor someday. Not so sure, right now.

I’m staying at a Marriott, and as usual their “iBAHN(R) Wireless High-Speed Internet” sucks. (I measure speeds with the CNet bandwidth tester; this hotel’s running at 400-500, compared to for instance the Sheraton New Orleans at 2500-4,000.)

I mentioned the speed problem to the excellent woman who gave me great service at the reception desk and she said they know, they’re trying to get out of their contract with iBahn.

“But,” I said, “if Marriott knows it’s bad, why are they still charging $12.95 a day for it??”

See, if you look at anything from the customer’s point of view, you just wouldn’t do that – would not charge full price for something you know isn’t working as you advertised it. (Advertised & sold as high speed; it isn’t, and you know it.) But I’ll guarantee there’s someone at the Marriott home office who views the situation one of these ways:
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September 17, 2013 By e-Patient Dave 3 Comments

“Better Health: Everyone’s Responsibility” – resources for today’s conference

Patients Included badge — Click to view Lucien Engelen’s “Patients Included” story on LinkedIn

For years we in the participatory medicine movement have been talking about the need to involve patients in all aspects of medicine – not just our own cases but even in the design of the whole system. The movement is exemplified by the Patients Included badge at right, created by Dutch health visionary Lucien Engelen.

Today I’m speaking at a truly extraordinary healthcare event in Hartford – it’s completely about, for, and aimed at the public – us ordinary people:

The title is right on target: “Better Health: Everyone’s Responsibility”
The event is scheduled from 12:45-8, so people only have to take a half day off work
Admission is $35 including dinner(!!), or $10 without(!!)

Over 500 local people (aka patients) are attending. For more, see the event’s website.

In my talk I’ll mention various resources participants can look up, to learn more about the movement and boost their own abilities. I’m going to publish this post now, and through the day I’ll add various things as they come to mind.

BIG thanks to the event’s organizers, the CT Partners for Health partnership and its founder Qualidigm. Here are some starter links: [Read more…]