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Engaging e-Patients
 

Engaging e-Patients

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Medical Grand Rounds at UMDNJ / Robert Wood Johnson Medical School 11/30/2011

Medical Grand Rounds at UMDNJ / Robert Wood Johnson Medical School 11/30/2011

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    Engaging e-Patients Engaging e-Patients Presentation Transcript

    • Engaging e-Patients: How Participatory Medicine Improves Healthcare for Both Patients and PhysiciansDaniel Z. Sands, MD, MPHSociety for Participatory Medicine,Cisco Systems,Beth Israel Deaconess Medical Center, andHarvard Medical SchoolBoston, MADZ Sands and RD DeBronkart © 2010 All rights reserved.
    • Dave@ePatientDave.com Twitter: @ePatientDave
    • Re-Connecting andAgenda-Setting
    • http://www.patientsite.orgCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Mail:Secure Services:Automated routing Prescription refillsTask assignment Appointment requests Referrals View billRecords:SecureAll CG recordsUpcoming appointmentsMeds/Problems/Results…Personal recordsEducation:Info prescriptionsPatient selected linksPredefined collectionsVideos
    • Dave (Pre-diagnosis) This is too cool. Its almost SILLY that things can be this easy. I am having a very good patient/customer experience so far.Cisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Hi - there are several things I want to goover when we meet. I suspect several willrequire referrals, and given the time ittakes to get a slot, Im thinking of makingthose appointments now. (Its easy tocancel and create an opening for someoneelse.) Im 56 and I generally dont haveany complaints.Here are the symptoms Im concerned about:[…]What do you think? Copyright © 2008 D. Z. Sands and R. D. deBronkart. All rights reserved.
    • The Visit
    • Using EHR in the Office  Three (not two) entities in the room  Sharing is encouraged when all align: – Attitude – Geometry – Communication habitsCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Exam Room Layouts Frankel R, et al. J Gen Intern Med. 2005; 20(8): 677–682.Cisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Exam Room Layouts Frankel R, et al. J Gen Intern Med. 2005; 20(8): 677–682.Cisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • The Incidental FindingCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • The Incidental Finding INDICATION: Right shoulder pain. COMPARISONS: Comparison is made to a chest radiograph from December 23, 2003. TECHNIQUE: Right shoulder, three views. IMPRESSION: 1. Degenerative changes of the acromioclavicular joint. Normal radiographic appearance of the glenohumeral joint. 2. 3.3 cm right upper lobe lung mass needs further evaluation with a chest CT to exclude malignancy.Cisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Diagnosis, Information,and Support
    • Lesion 1 – Left Upper Lobe 39x43mmCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Primary Tumor FoundCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Beautiful but Deadly: Renal Cell CarcinomaCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • “Textbook” Stage IV, Grade 4 Renal Cell Carcinoma… with a few more lesions for extra credit Illustration of Stage 4 RCC from Proleukin.com, augmented by e-Patient Dave Copyright © 2008 D. Z. Sands and R. D. deBronkart. All rights reserved.
    • ACOR is great. I posted two messagestonight and got responses in 4 and 11minutes. One responder also sent a privatenote mentioning Robin and Cathy. The otherresponder was Cathy. :)Through that list Ive also found severalother useful sites. Copyright © 2008 D. Z. Sands and R. D. deBronkart. All rights reserved.
    • Cisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Successful Treatment Baseline: 39x43 mm 50 weeks: 20x12 mmCisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • “Knowledge is power.” Sir Francis Bacon English author, courtier, & philosopher (1561 - 1626)Cisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Shifting Paradigm? !  Information asymmetry –Physician as oracle –Comfortable –A burden?  Information symmetry ! ! –Physician as partner –Threatening vs. liberating ☺ –Physician as healerCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Two Types of Information in HealthcareCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • The Power of “I Don’t Know”Cisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • It’s Not About Technology…Cisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • … It’s About Engagement Engaged Equipped Empowered Educated Enlightened Etc.Cisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • But Technology Can Lower BarriersCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Because of Web, Patients Are Connected to Information and Each Other (and to Doctors)Cisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • e-Patients  84% of online adults  Rising over time  Each day, more people search for health information than see a physician!  More than half act on the information Source: www.pewinternet.orgCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • E-Health in 3 Easy Steps Break the Ice Learn from them Assist themCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Learn and Teach Skills for Health on Web  Qualities of good versus bad sites  Deciphering medical jargon  Don’t be afraid to ask  Resources: – http://www.mlanet.org/resources/consumr_index.html – http://www.vuw.ac.nz/staff/alastair_smith/evaln/evaln.htmCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Honest AskingDisclosures Trusting Relationship Tacit Approval
    • Encouraged $ Tertiary Professional Secondary Care Primary Self-CareDiscouraged (Off the Map) ¢Source: Ferguson, T. Consumer Health Informatics. Healthcare Forum Journal, 1995.
    • Encouraged ¢ Individual self-care Friends and families Self-help networks Professional as facilitatorsDiscouraged Professionals as Professional Care partners Professionals as $ authoritiesSource: Ferguson, T. Consumer Health Informatics. Healthcare Forum Journal, 1995.
    • Patient and Physicians Each Have ExpertiseCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Patients Can (and Must) HelpCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • “It can be argued that the largest yet most neglected health care resource, worldwide, is the patient…” Slack WV. CyberMedicine: How Computing Empowers Doctors and Patients for better Health Care. Jossey-Bass 2001.Cisco IBSG © 2010 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Changing Nature of Relationship Information Information Asymmetry Symmetry Passive Recipient Active Partner Paternalism Participation Patient-Physician Consumer-ProviderCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Participatory Medicine is a movement in whichnetworked patients shift from being mere passengers to responsible drivers of their health, and in which providers encourage and value them as full partners. http://ParticipatoryMedicine.orgCisco IBSG © 2011 Cisco and/or its affiliates. All rights Cisco Confidential Business Transformation Group reserved.
    • Conclusions  Physicians must engage patients  Patients must learn to play a participatory role  Connected technology lowers barriers to engagement and empowers: –Patients –Practices/health care organizations –Providers  Participatory Medicine is an important paradigm shift –Improves outcomes and reduce costs –More study is needed  Ask yourself: – Why did you go into medicine? – What kind of a doctor did you want to be?Cisco IBSG © 2010 Cisco and/or its affiliates. All rights reserved. Cisco Public Internet Business Solutions Group
    • Questions? danny@dannysands.com Twitter: @DrDannySandsSlides: http://www.sideshare.net/dzsands