Comarow on Quality

Avery Comarow's blog on USNews.com is my personal find of the week. I once worked with Avery, so I know he tells it like it is, and he's tackling an important topic. Check out his take on the CMS Hospital Compare page: Hospital Deaths Go Public.

Now THAT's an e-participating patient

From ScienceRoll: "Jan Martens at Medblog.nl ... mentioned Maarten Lens-Fitzgerald who should be considered one of the best examples of e-patients in the world. See why..." Hey Jen McCabe Gorman, what is it with the Dutch?

Pez Dispensers = Inspiration

Check out the Diabetes Mine Design Challenge winners for examples of how e-patients can help heal health care, as we like to say around here. I'm especially taken with the Pez dispenser-inspired Maximum Slide gadget, but then again I may just be charmed by the comic book presentation of their idea.

Welcome, "Reasonably Well"

The Reasonably Well blog is authored by Julia Schulia, a patient of Sjogren's Syndrome, a progressive autoimmune disease. She read the e-patient white paper (have you?), and she gets it. Welcome to the family!

How do US journalists cover medical news?

A really interesting evaluation of 500 medical stories from the press covering treatments,tests, products & procedures is available at PLoS.

This should be required reading for anyone interested in the power of e-patient groups, since these groups very often debunk improperly reported news.

Nice Review at Consumer Reports

Orly Avitzur, a neurologist and e-Patient savvy doc, is now a medical editor at the Consumer's Union/Consumer Reports. She's written an excellent short review of some of the important developments in what we've come to call participatory medicine that can be found at the Consumer Reports Health Blog. I recommend it.

Unimplementable standards: seedie.org

A tip of the e-hat to Dr. Ted for this *splendid* reading for people involved in EMR/PHR:

SEEDIE: Society for Exorbitantly Expensive and Difficult to Implement EHRs.

Don't miss the sub-pages.

Here Comes Everybody

Over on the Inkwell, our own Jon Lebkowsky is interviewing Clay Shirky, author of "Here Comes Everybody."

My favorite quote so far: "The places where experts matter
and flourish are places where it is expertise, rather than authority
(which is to say knowledge and experience, rather than imprimatur and
access to public expression) that give them their voice."

What patients really want

What patients really want: an introduction to the e-patient" cites our own Dr. Danny Sands in his video editorial on Medscape.

Patient Activism

If you have doubts about the impact of social media on health care, please read this 2005 post on The Health Care Blog about a grandmother's campaign on behalf of her grandson. There's a lot of heart (and snark) in the comments.

Um, let's start by just being polite

Maybe it's just me, but this one's a little astounding.

According to Paul Levy's blog, a Perspectives column in the New England Journal of Medicine "suggests that doctors enhance their relationship with patients when they deal with [them] in a polite manner." Well, that's a start!

Seriously, it seems primitive, but I'm glad to see a publication taking seriously the idea of treating us consumers like people who deserve respect and common courtesy. It's a step toward getting everyone in the care community to treat us as humans who need care, not jostling. (Disclaimer: I'm a patron of the author's hospital, which has almost always treated me well.) --e-Patient Dave

No Secrets

Ted Eytan's April 16, 2008, iHealthBeat column lays out the benefits of providing real-time, secure access to health records: "As our profession understands the benefits of patient partnership better, more medical groups are discovering that there aren't compelling arguments for keeping patients' information secret."

Doctors Discuss How to Deal with e-Patients

"A well-educated patient is easier to treat. A badly educated patient is very difficult to treat."

This and other choice quotes you'll find in, How to deal with the digitally empowered patient, a four-doctor roundtable discussion hosted by Scott V. Haig, MD. an Assistant Clinical Professor of Orthopedic Surgery at Columbia University. It was published in the April 2008 issue of Orthopedics Today.

Patient 2.0

Check out this interview with Matthew Zachary, founder of ImTooYoungForThis (cancer resources for GenX and GenY).

The Players in the PHR Space

Want to know who wants to be your next personal health record (PHR) provider? Check out this great run down of the current players in the PHR market, along with some insights into what motivates them to be the company between you and your personal health information.

September 4, 2008
Not Just a Pretty Picture

The Journal of the National Cancer Institute published health risk data in a way that only a researcher would love (Reason.com's Hit & Run blog links to the subscription-only charts here in case you want to marvel at the ugliness). Luckily The New York Times took notice and painted a picture that everyone can appreciate. Can good design can make a difference in health care?

posted by Susannah Fox | comments (1) | send to a friend | permalink



September 3, 2008
Eyeballs AND Data, Please

Jeff Howe's blog post, "Can We Crowdsource Medical Expertise?" elicited the following comment from Daniel Reda of CureTogether.com: "Personally, just like I have batting averages, crash test ratings and historical earnings, I'd like to see the data on whoever interprets my MRI and whoever makes my diagnosis, regardless of whether it's an amateur in a foreign country or the chief of staff at the world's 'best' medical center."

This comment, and Howe's post, get to the heart of participatory medicine. I would love to hear what people think about "crowdsourcing" and health care.

posted by Susannah Fox | comments (3) | send to a friend | permalink



September 2, 2008
What's in *your* MIB?


A week ago Ted Eytan posted about a Consumer Reports Health blog post, including a video of a patient who is unable to get health insurance because of an error in her MIB - her Medical Information Bureau record, very much like your credit bureau record. As a direct result of the error, she's exhausted the last bit of her 401(k) and expresses concern about not maxing out her credit cards. (And she still doesn't have insurance.)

A healthy discussion ensued in the comments there, ending with my deciding to phone the MIB and get my once-a-year free copy of my record. It arrived today, and it's eye-opening – not because of errors per se, but because of the nasty little details between the lines.

As it happens, I got a glimpse into that system just as the doors closed. Given the opacity of the system, I shudder to think about my chances of correcting any error. Here's what happened.

continue reading "What's in *your* MIB?"

posted by e-Patient Dave | comments (2) | send to a friend | permalink



August 26, 2008
Health System Change: Collaborative Researchers

Ha Tu and Genna Cohen of the Center for Studying Health System Change released their latest report on how Americans gather health information (HTML report; news release).

I met with them in June and learned a bit more about how they approached this massive data set (N=18,000+).

continue reading "Health System Change: Collaborative Researchers"

posted by Susannah Fox | comments (2) | send to a friend | permalink



August 25, 2008
Doctors' Digital Footprints

Is it "disordered" behavior to Google your doctor? An article in JAMA suggests that doctors be on their guard.

continue reading "Doctors' Digital Footprints"

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August 13, 2008
Latinos' sources of health information

The Pew Hispanic Center and the Robert Wood Johnson Foundation released a report today that is required reading for anyone interested in a more nuanced picture of the e-patient population: "Hispanics and Health Care in the United States: Access, Information and Knowledge."

continue reading "Latinos' sources of health information"

posted by Susannah Fox | comments (6) | send to a friend | permalink



August 7, 2008
Monique tells why she doesn't see herself as "e"

I'm delighted to present a guest post from cancer patient Monique Doyle Spencer, whose husband found the henna relief for hand-foot syndrome we mentioned yesterday. She is a stitch. To me she's about as empowered as they get, but she says she's always felt a bit cowed by all this e stuff. We persuaded her to gift us with an essay. --e-Patient Dave


It used to be true: I didn’t understand this “e” thing -- e-patientcy, e-patienthood, e-patience, e-patient-nation. I was more of a d-patient – disengaged, disinterested, detached. The only “e” I had was “electronic,” but why would I use that “e” for medicine when there are so many jokes to find and I have a discount coupon for www.more.stuff.i.want.and.if.i.buy.even.more.ill.get.freeshipping.com?

continue reading "Monique tells why she doesn't see herself as "e""

posted by e-Patient Dave | comments (1) | send to a friend | permalink



August 6, 2008
e-Patient finds henna relief for Hand-Foot Syndrome

Update 8/9/08: Monique posted the detailed instructions she uses at the blog she started for Xeloda side effects.

Monique Doyle Spencer, author of the fabulous book The Courage Muscle: A Chicken's Guide to Living with Breast Cancer, is on Xeloda, and is experiencing a painful side effect called Hand-Foot Syndrome (HFS), which happens with some other cancer treatments too.

Doing classic e-patient-style research, her husband found an amazingly simple and effective relief - a paste of henna, lemon juice, and hot water. She was skeptical ("I don't even own a single Enya CD"), but it worked.

She notified Roche, maker of Xeloda, and was rather unhappy about their form-letter lack of interest in telling anyone else.

Her op-ed about it in the Boston Globe is here, and the discussion on Paul Levy's "Running A Hospital" blog is here.

Be sure to read the extensive comments, which show the vigorous patient-centered dialog that often happens on Levy's blog, even though it roams to other subjects, as often happens on a blog where people actually get to say what they think.

posted by e-Patient Dave | comments (0) | send to a friend | permalink



August 1, 2008
New e-patient population estimate

The Pew Internet Project released the latest estimate for the e-patient population: 75% of internet users. Details on this and an upcoming survey follow...

continue reading "New e-patient population estimate"

posted by Susannah Fox | comments (8) | send to a friend | permalink



July 31, 2008
Interview: Mary Matthiesen, Conversations for Life

Mary Matthiesen, founder of Conversations for Life, has 17 years of front-line experience in healthcare, end of life care, and executive leadership. She's a transpersonal educator, coach, and community facilitator, raising awareness and promoting social change in support of living and dying well. Mary and I recently discussed her focus on end of life care, and its relevance for e-patients.

Jon Lebkowsky: What led to your focus on end of life experience?

Mary Matthiesen: If I had to pinpoint a moment, it was in a hospital hallway, listening to a father tell me with pride about his daughter's life and how much he loved her as she lay in a bed down the hall. It was her 'dying wish' to be an organ donor if possible. She was in her 40's and had a brain injury that led to "brain death'-(a legal definition of death in the U.S). We were awaiting, together, the outcome of some lab tests to see if she could be an organ donor as her parents knew she'd wanted.

continue reading "Interview: Mary Matthiesen, Conversations for Life"

posted by Jon Lebkowsky | comments (3) | send to a friend | permalink



July 29, 2008
Is ANYONE responsible for the whole patient?

The e-Patients Group has been discussing Shannon Brownlee's book Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, which tells how the logic of the U.S. healthcare system works against coordination and effective treatment. "Between 20 and 30 cents on every health care dollar we spend goes towards useless treatments and hospitalizations, towards CT scans we don’t need, towards ineffective surgeries—towards care that not only does nothing to improve our health, but that we wouldn’t want if we understood how dangerous it can be."

One crucial issue we've been discussing is the lack of coordination among healthcare providers and resulting treatments based on fragmented understanding of the patient's whole profile.

Suffice it to say, the e-Patients Group is not of one mind on this subject, due in large part to the different set of major challenges faced by the doctors and patients among us, both fighting for their breath in this dysfunctional system. Below are some excerpts from our respectful but strong-willed expressions of views.

continue reading "Is ANYONE responsible for the whole patient?"

posted by Jon Lebkowsky | comments (7) | send to a friend | permalink



July 28, 2008
Medpedia - where are the patients??

Medpedia has gotten a lot of publicity in the past week. Considering that Wikipedia has disavowed* usefulness for patients, Medpedia sounds like a potentially great idea. * See Jon's correction in Comments. --EPD

But when I saw their home page it literally took my breath away: there are invitations for doctors to join, and organizations to contribute content, but nothing for patients – we can contribute ideas, not content.

Well, I clicked the Contribute Ideas link, and you bet I submitted an idea:

continue reading "Medpedia - where are the patients??"

posted by e-Patient Dave | comments (4) | send to a friend | permalink



July 26, 2008
Take control of your images!
Where to get DICOM readers
Why I'm writing about this: Linux guru Doc Searls wrote a profound piece last month about inability to read his own medical images, which led to inappropriate surgery with severe consequences. This could happen to you. Our Jon Lebkowsky wrote a superb and enlighting post about it, which opened my eyes to a new (for me) dimension of patient empowerment: whose data is it, anyway?

continue reading "Take control of your images!
Where to get DICOM readers
"

posted by e-Patient Dave | comments (4) | send to a friend | permalink



July 25, 2008
An e-Patient Hero Leaves Us

Most of us know Randy Pausch from his video lecture "Achieving Your Childhood Dreams", taped at Carnegie Mellon as part of their "Last Lecture" series. His hope and optimism in light of a crushing diagnosis brought millions up short as they examined their lives through the lens of this great man at the end of his short life. What you may not know is that Randy was an e-Patient. He was engaged in his own healthcare to the very end and shared his journey freely with the world.

continue reading "An e-Patient Hero Leaves Us"

posted by Cheryl Greene | comments (3) | send to a friend | permalink



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quote-a-matic
The current doctor's visit is inadequate for both physicians and patients.
—Harris Healthcare Satisfaction Study