The document discusses how participatory medicine can help improve the practice of medicine by better utilizing patients. It notes that the total value of care comes not just from what providers do during visits, but also what patients do between visits. It suggests finding ways to optimize the patient's contribution, such as making it easy for patients to do the right things through providing them with needed information, tools, and an supportive environment. This can be facilitated through eHealth technologies that deliver data, alarms and processes to improve the value of care by empowering patients with information and assistance.

1. JAMIA, 1997
Participatory Medicine
Can Help Improve
the Practice
of Medicine

2. “The resource
that is most often
under-utilized –
our patients”
Charles Safran MD, Beth Israel Deaconess
quoting his colleague, Warner Slack MD
Testimony to the House Ways & Means
subcommittee on health, 2004

3. Total value of care =

4. Total value of care =
value created by
providers (in visits)

5. Total value of care =
value created by
providers (in visits)
+ value created by
patients (between visits)

6. How can we optimize
the patient & family’s
contribution?

7. Compliance
(Whose goal is it, anyway?)

8. Compliance
(Whose goal is it, anyway?)

9. Peter Margolis, Cincinnati Children’s
.5 x .5 = .25

10. Gilbert’s matrix of
performance improvement
(Thomas F. Gilbert, 1927-1995)

11. Gilbert’s matrix of
performance improvement
(Thomas F. Gilbert, 1922-1995)

14. Ingredients of an effective
response to a situation:
• Does the person know
what needs to be done?

15. Ingredients of an effective
response to a situation:
• Does the person know
what needs to be done?
• Do they know when it needs to be done?

16. Ingredients of an effective
response to a situation:
• Does the person know
what needs to be done?
• Do they know when it needs to be done?
• Do they know how to do it?

17. Ingredients of an effective
response to a situation:
• Does the person know
what needs to be done?
• Do they know when it needs to be done?
• Do they know how to do it?
• Do they have the information they need
to do it successfully?

18. Ingredients of an effective
response to a situation:
• Does the person know
what needs to be done?
• Do they know when it needs to be done?
• Do they know how to do it?
• Do they have the information they need
to do it successfully?
• Can they tell when it’s complete?

19. Can we
make it
easy
to do
the right
thing?

20. Can we
make it
easy
to do
the right
thing?

23. Ingredients of an effective
response to a situation:
• Does the person know
what needs to be done?
• Do they know when it needs to be done?
• Do they know how to do it?
• Do they have the information they need
to do it successfully?
• Can they tell when it’s complete?

24. eHealth
(data, alarms, processes)
can help improve value
with information, tools,
and environment

25. JAMIA, 1997
Let Patients Help.

26. JAMIA, 1997
Let’s make it EASY
for patients to help.
Society for Participatory Medicine
www.ParticipatoryMedicine.org / e-patients.net
www.ePatientDave.com dave@epatientdave.com
Twitter: @ePatientDave