e-Patient Dave

Power to the Patient!

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Do you know what’s in YOUR (health) wallet??

VeHU audience poll question resultsI’m at the gigantic HIMSS health IT conference in Orlando, in the consumer pre-conference. In my opening talk I briefly mentioned something I’ve said for years:

Have you looked in your chart? Your medical record? Do you know for a fact that there are no errors in it?

Most audiences appear intrigued and thoughtful at this. But ha ha ha, at HIMSS (people who work in health IT), on Twitter there are two interesting reactions:

  • Several different people tweeted it, showing unusual interest in it, and more than a dozen retweeted those
  • And, a whole bunch of people are saying “Who says?? What’s the source??” 

How fascinating. Well, here’s what I know about it.

  • 18 months ago I spoke at the Veterans eHealth University, a virtual university for people who work in the VA (veterans’ administration) health system. They asked me to submit some interactive audience response questions.
  • One was to ask the audience if they had checked their own record. The results are in the slide above. (Sorry about the typos – that’s how the A/V guys typed it into the computer.) Results:
    • 50 / 66 (76%) said no, they’d never looked. (Have you?)
    • Of the 16 who had looked:
      • 5 (31%) weren’t sure whether there were errors.
      • Of the 11 who were sure:
        • 7 found mistakes (64%)
        • 4 found the record was perfect (36%)

So, roughly: of those who had checked, about 2/3 found mistakes: missing allergies, wrong medications, wrong diagnoses, etc.

Since then, depending on the audience, I’ve asked this of other audiences. Every time of those who’ve checked, about 2/3 found errors. Every time.

This is not a peer reviewed journal article.  I’d love to see one! I also encourage all health IT speakers to ask their own audiences. Maybe mine aren’t typical, somehow.

And by the way – if you’re skeptical, do you know if your record contains everything doctors and nurses should know about you, and doesn’t contain errors?

As always, discussion is welcome!

It’s like the old Capital One commercials – do you know “What’s in your wallet?”

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Updates added later:

  • At the British Columbia Patient Safety & Quality Council conference later that week, in a post-keynote workshop, I asked the room about this:
    • Of more than 100 in the room, eight had examined their entire records.
    • Of those, six had looked errors, and two had found them completely accurate.

 

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Finally! Composite video of my call to action at Blue Button Plus Developer Challenge (New York, July 22)

Blue Button Plus event artLast month I blogged that a “lost speech” had finally surfaced. It was my closing speech at an event last July, and said why this moment (this year, this series of conferences) is an essential turning point:

“The event was a conference conducted by our Department of Health & Human Services to educate and encourage software developers about the “Blue Button Plus” initiative. … which is really important for the future of health IT, and not just in America; this innovation initiative will change what patients and families are capable of.”

And I said:
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Video of my AMIA keynote is live

In November I posted about how fun my opening keynote was at AMIA, the American Medical Informatics Association. See that post for tweets from the event and discussion.  It was great fun – a conference of 2,000 information science geeks – people who understand data, especially what it’s for and why data quality is important!  Boy does it save time when you start from a common view.

This week AMIA’s Jeff Williamson got  me the video of the speech.  Here it is, with Dr Danny Sands introducing me. (He’s one of the revered figures in the association; they’re also the ones who published his 1998 article on doctor-patient email.) See notes below about what makes this talk different from others. Dr. Sands starts by noting that it was 50 years since JFK’s assassination.

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Prize-winning Consumer Reports app seeks study participants: Hip or Knee Replacement

For U.S. residents – 

I spoke last month at a health price transparency conference in Washington, sponsored in part by Robert Wood Johnson Foundation. In a side session we saw presentations by the winners of the Health 2.0 Developer Challenge Consumer Reports logofor shopping tools. Consumer Reports won first place for shopping apps for their Hospital Advisor: Hip & Knee app. (The link has their demo video.) It’s a fabulous tool for comparing prices and quality for hip and knee replacements.

Now they’re expanding the data behind the app, so they want information from us. Team member Chris Baily sent this request – feel free to share widely:
_________________

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The Lost Speech: “Blue Button Plus” developer conference, New York, July 22

Screen grab of shot from YouTube of my talk
Click to view the video on YouTube

This is a quickie post – at long last the video of one of my favorite speeches ever has been unearthed. It was in July in New York, and somehow it got lost, and arrived in my inbox today. (Well, actually, they posted it three months ago but forgot to tell me!)

All’s well that ends well. I just want your help in a BIG push to spread the word about this!  Time’s a-wasting!

The event was a conference conducted by our Department of Health & Human Services to educate and encourage software developers about the “Blue Button Plus” initiative. Because I’m on vacation I’ll leave it to you to google that phrase, which is really important for the future of health IT, and not just in America; this innovation initiative will change what patients and families are capable of.

Unfortunately the video crew that day apparently didn’t realize I was showing slides that might also be part of the presentation (d’oh!) so they only took video of me. So the slides are on a separate site, Slideboom, embedded below, and they’re not synchronized to the video – if you want to see both you’ll need two monitors (ugh) and you’ll need to guess at when to click:
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“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.
__________

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.