e-Patient Dave

Power to the Patient!

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Vigilance is valid: New rule for the culture of safety

Photo of David NashDavid Nash is Dean of the School of Population Health at Jefferson University (@JeffersonJSPH) in Philadelphia. Last week at the Maine Hospital Association’s (MHA) Summer Forum he and I both spoke. His talk was titled “Demand Better: Revive Our Broken Healthcare System.”

I hear a lot of speeches, and this one hit me between the eyes in a number of ways, combining some facts I’d heard before in new ways, mixed in with personal experiences. I hope to blog about several of these points (with his blessing); this is the first.

The story

The appendix of Let Patients Help is titled “Stop the Denial.” It’s about the reality that medicine is inherently hazardous, and medical staff pretty much work without a net. As I like to say, “In my own work I live through the Undo key, but clinicians don’t have one.” And they don’t work in a system that prevents human error.

Result? As the book says,

Did you know that in the best hospitals in America, 1 in 20 surgical patients dies of a complication? After the surgery? [HospitalSafetyScores.org] (In the worst hospitals it’s 1 in 6.) Hard to believe, yes?

If you were considering surgery, wouldn’t that change your thinking? Wouldn’t it make “Let’s wait a bit” seem like a prudent thought?

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All patient/consumer groups – PLEASE ACT. Our families need full data on finding the best providers.

Diagram of where to clickI made several corrections to the numbered paragraphs, 2:30 ET

Time is short – deadline Tuesday.
Please forward to any individual or association who can act.

For convenience, I’ve tried to condense the issues and actions as much as possible.

Everyone in the U.S. can participate – every individual, citizen or group. Add your voice.

If you have questions, ask in comments.

1. The issues – my view

This was brought to my attention by Leah Binder, CEO of Leapfrog Group in DC, about whom we’ve often written here and on e-patients.net. They’re major fact-based safety advocates – all about the data. And as I’ve always said, we all perform better when we’re informed better.

So to me, hiding data from us is disempowering, and it dis-enables the market forces that reward the best.

The issue here is  some new rules regarding what data our government shows us about the safety performance of different hospitals. In the current batch of proposed changes there are many good things, but three items concern me greatly, and I think anyone who believes in informed consumer choice must act:

    Comparison of five hospitals' data (click to open PDF)
    Comparison of five hospitals' data from this report (click to open PDF)

1. We need data for individual hospitals, not just the whole company. YIKES! Would you want that in auto safety? Would you want to hear that on average a certain brand is reliable, but have them hide that certain models explode or roll over?? But that’s exactly how it is in medicine. Consumer families need better information.

  • This is no small issue – in the example at right, the four hospitals that got grades of A through D are all part of the same company. Do you want that data hidden, so when your relative gets sick, all you know is the company’s overall average??
  • Remedy: demand that we continue to see the data for every hospital!
  • Note – this isn’t just a consumer rights issue – if the best providers aren’t paraded, how can the market reward them?

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Newest speech video: SAS Institute health analytics – business / tech / data conference

SAS speech video page screen capture

My videos page has recordings of various speeches. Here’s the latest – and, some are saying, my best. It was a month ago in Cary, North Carolina, at a big event conducted by SAS called “Health Analytics: From Big Insights to Big Breakthroughs.” It’s 56 minutes long.

Here’s the direct link to the video. If you’re not already registered on that site, you may need to register here.

Not all the slides are shown in the video; here’s a copy of them on Slideshare. Slideshare’s display software is pretty weak compared to what I do with PowerPoint :-) so some of the layouts display wrong on their site, but you can get the idea.

Don’t miss Peter Diamandis’s talk that day

Near the beginning I mention it. Here’s the link.

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Seven days to go; 81% there! Please back Regina’s film project!

Please click this image, watch the two minute video, and donate what you can.  This is THE famous Regina Holliday, who has been called “the Rosa Parks of healthcare.”  You’ll see why.  A humble but immensely strong woman who has become the leader of a movement made almost literally with her bare hands.

This modest $10,000 fundraising project (very little for a film) is one week away from completion, and has less than $2,000 to go.  As I said on Facebook when it was $2500, let’s find two $1,000 donors and dozens of $20 ones!

Click it and read. Get your name in the credits, if you’ve got the scratch!  (If you have one of these jackets, you must donate; even if you don’t and you just love supporting a great new future, pitch in!  I did.)

Screen capture - click to donate

Incentives include a shirt, a copy of the DVD, and all the way on up to Regina coming to your company or club and doing a speech or even a lecture!

And she might even paint for you.

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Weird trick for patient-centered care: Care what matters to patients

Image source: FreeDigitalImages.net, by digitalart

It seems these days internet ads get high click-through rates if they start with “Weird trick.” I’m game. For patient centered care, the weird trick is to think about this:

Listen to what matters to patients (ask them),
and decide that it matters to you.

You’ll see things from their point of view,
and you’ll become patient centered.

I know it’s weird, but think: when patients tell you something’s bothering them, do you say “Sorry, there’s nothing we can do about it”? That’s the hallmark of being disempowered. Or do you do something about it? Or as your team to see if you can?

For instance, noise: I just learned that some hospitals are letting people put up a Do Not Disturb sign! Hard to imagine? It’s in a great Wall Street Journal piece yesterday by Laura Landro.
____________

So, what is this “patient centered” thing?

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Make it EASY to manage my pillbox!

Blue Button logo

Vote us up! (Alicia Staley and me)
Click to visit our proposal on the site, register if you need to,
and use one of your votes for this awesome idea!

(Or all three of your votes. :-) It’s allowed.)

Have you ever seen the set of pills that have to be managed for a person with a slew of prescriptions?  It’s nuts. What’s even more nuts is that with all we pay for healthcare and computers in this world, there’s no software anywhere that makes it easy to do the right thing. Let’s change that!

(I’m not complex at the moment (at least my prescriptions aren’t), but when I was sick I sure was. Farther down is the true story that gave me this idea.)

This is my submission for the “Blue Button CoDesign Challenge” that was sprung on us last Monday by the good folks at Health & Human Services, who are doing this radically modern thing – unusual for government, eh?  They came up with a fascinating challenge and are opening it to the public, with prizes! For details you can check out the challenge site.

Here’s my proposal. Over the weekend I’ll flesh out this blog post with more details, but for starters Friday afternoon, here’s the big idea:

Build me a Blue Button enabled tool that….

… makes it easy to manage our frickin’ prescriptions and take the right pills at the right time!

My doctors’ computers know my prescriptions and when I’m supposed to take them, right? So do the pharmacies. And computers can mash up all kinds of information from different sources, and organize it, and display it clearly, right? So why do they make ME figure out when I should take what?

Let’s have an app that can read all my prescriptions, and organize them into times of day. Even better, it could print out my pillbox and add pictures of what goes in each square. Why not?? Isn’t that what computers do – make complex information easy??

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