Communication Technology and Health 2.0 for ACP Internal Medicine 2011Presentation Transcript
Engaging e-Patients: How e-Messaging, Social Media, and Patient Activation Can Transform Your Practice
Daniel Z. Sands, MD, MPH, FACP, FACMI
Cisco Internet Business Solutions Group,
Beth Israel Deaconess Medical Center, and
Harvard Medical School
President, Society for Participatory Medicine
Daniel Z. Sands, MD, MPH, FACP Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Disclosure of Financial Relationships Cisco Systems, Inc.: Employee and Shareholder
How Crucial is Communication in Healthcare? “… communication extends all the way from the intimate interaction between a clinician and a patient, to the most public dissemination of information.” Harvey Fineberg, MD, PhD President, Institute of Medicine
Many Reasons for Collaboration
Sharing and co-creating knowledge
Many Transitions Across Care Continuum … Home / Self-care Inpatient Care Emergency Care Ambulatory Care Post-acute Care
Collaborative Planning Improves Transitions in Care Each step requires collaboration Discharge or Transfer Planning Admission Admission Planning
Two Types of Connections Deliver the right information to the right person for the right patient at the right time Connect to the right person about the right patient at the right time
Human Connections are as Important as Data Connections in Healthcare Connected Life Sciences and Research Connected Hospital Connected Clinician Connected Health Information Exchanges Connected Health Authorities Connected Patient Connected Public Health Connected Funder or Payer
Many Tools for Communication…
… And Reaching People is Difficult Source: Forrester Research, February 2006 “ Every minute engaged in tracking and locating others reduces a nurse’s availability for the patient .” 66% Search more than one channel to reach staff 84% Time spent trying to reach staff impacts patient care 65% 20-60+ min / shift just trying to reach staff
> 50% pages received by first-year medical residents were considered non-urgent and frequently interrupted the care interns were delivering to a patient at the time (Katz M.H., Schroeder S.A., NEJM 1988. 319:4)
Hospital clinicians made successful connection 74% of the time, and ¼ of the calls associated with determining who needed to be contacted for a specific situation (Coiera E., Tombs V., BMJ February 28, 1998)
The value of high quality communication systems and processes measured in Buckles and Herrin 2007, and Kuruzovich et al. 2010.
Connecting with Patients: e-Communication
e-Communication includes encrypted e-mail or, more commonly, secure web messaging
e-Communication can provide an efficient means of communication because it is asynchronous
This is cost-effective and benefits both patients and physicians
Changing the Way We Work “ We are looking to technology to reduce administrative costs as well as direct care delivery costs… Collaboration plays an important role in both strategies.” — Terry Bayer, Chief Operating Officer, Molina Healthcare Text Voice, Video Number of Stakeholders Medium Documents Few Many Email IM TelePresence Unified Communications Vmail Discussion Forums Video on Demand Wikis Blogs Contact Center Conferencing Social Networking
Telemedicine as Collaboration with Patients
Many to many connection—routed based on network intelligence
Can recreate “up close and personal” experience
Telemetric data transmission
Attributes of Technology Channels Technology Synchronous? Information Density Telephone E-messaging Text messaging/IM / Remote monitoring Telemedicine (usually) Advanced Telemedicine Office visit
Different personnel can provide care
Each has attributes
Each should practice at “top of their license”
Can add others to this list, even perhaps, Watson…
Social networking sites (e.g., Facebook, LinkedIn)
Physician Concerns Re: Health 2.0
All CG records
Patient selected links
54M Consultant with HTN, Hyperlipidemia
This is too cool. It's almost SILLY that things can be this easy. I am having a very good patient/customer experience so far.
61M Minister with DM and Chronic Pain
I have a lot of medical issues. This email system has left me feeling comfortable and in good hands! Otherwise, I would feel as cold, depleted, and alone, as the lifeless tree in my front yard in the deepest of winter!
Wikis: The Wisdom of the Crowd The wisdom of the crowd refers to the process of taking into account the collective opinion of a group of individuals rather than a single expert to answer a question. This process, while not new to the information age, has been pushed into the mainstream spotlight by social information sites such as Wikipedia and Yahoo! Answers, and other web resources that rely on human opinion.
Twitter’s Value to Me
Information/links/opinions from people I trust
Can search, scan, drill down
Platform for me to share ideas
Build community of followers/build my brand
Determine zeitgeist of conferences I did not attend
Share key points of conferences (for others and for me)
“ We met online.”
What are Social Networks?
Illuminate our social and professional networks
Expand our communication options
Provide context and meaning to our communication
Validate who we are through our associations
Patient Network Plus:
Patients’ sharing detailed health data is what makes our communities special. This information is the basis of the PatientsLikeMe network and validates each individual
LEARN The shared information creates a new knowledge about the real world treatment , symptoms , and reality of living with illness. Patients learn about their disease and themselves in context of the community FIND Patients’ find other patients like them. They discover what options are available for treatment and if their experience with their disease is normal. They can reach out to others like them for advice and insight.
Medical Professional Social Networks
Social Network Analysis By Nicholas A. Christakis and James H. Fowler
“ Knowledge is power.” Sir Francis Bacon English author, courtier, & philosopher (1561 - 1626)
Information Needed for Knowledge
Physician as oracle
Physician as partner
Threatening vs. liberating
Physician as healer
! ☺ ! !
The Power of “I Don’t Know”
85% 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
Professional Care $ ¢ Source: Ferguson, T. Consumer Health Informatics. Healthcare Forum Journal, 1995.
Professional Care ¢ $ Source: Ferguson, T. Consumer Health Informatics. Healthcare Forum Journal, 1995. Professionals as partners Professionals as authorities
http://participatorymedicine.org Participatory Medicine is a movement in which networked patients shift from being mere passengers to responsible drivers of their health, and in which providers encourage and value them as full partners.
Patient and Physicians Each Have Expertise
Patients Can (and Must) Help
“ 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.
Because of the Web, Patients Can Connect to Information and Each Other (and to Doctors)
Changing Nature of Relationship Information Asymmetry Information Symmetry Passive Recipient Active Partner Patient-Physician Consumer-Provider Paternalism Participation
Human connections as important as data connections
Collaborations are key!
Many newer tools for connecting and collaborating
Collaborations can improve care of patients
Considering patients as collaborators yields benefits
Health 2.0 tools useful to both patients and providers
Helps shift balance of power
Lowers barriers to engagement
Empowering and enabling to patients and physicians
Physicians must learn how to better engage e-patients
Questions and e-mail address Questions? [email_address] Twitter: @DrDannySands http://www.facebook.com/DrDannySands http://www.linkedin.com/in/DannySands