Illness in the Age of \'e\'

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  • Illness in the Age of \'e\'

    1. 1. Illness in the Age of ‘e’: A Case Study in Collaborative e-Medicine Daniel Z. Sands, MD, MPH Cisco Systems and Harvard Medical School Boston, MA Dave deBronkart, SB Blogger ‘e-Patient Dave’ Nashua, NH Harvard Medical School
    2. 2. Re-Connecting and Agenda-Setting
    3. 3. http://www.patientsite.org
    4. 4. Dave (Pre-diagnosis) <ul><li>“ 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.” </li></ul>
    5. 5. Hi - there are several things I want to go over when we meet. I suspect several will require referrals, and given the time it takes to get a slot, I'm thinking of making those appointments now. (It's easy to cancel and create an opening for someone else.) I'm 56 and I generally don't have any complaints. Here are the symptoms I'm concerned about: […] What do you think?
    6. 6. The Visit
    7. 7. The Incidental Finding Incidental finding: Shadow indicates mass in upper lobe of right lung X-ray taken Jan. 2, 2007 by orthopedist to diagnose rotator cuff disease
    8. 8. 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. Radiology report as displayed on PatientSite
    9. 9. The Work-up, Diagnosis, and Support
    10. 10. Lesion 1 – Left Upper Lobe 39x43mm Note: This is the left lung – opposite side from the lung in the x-ray
    11. 11. Sample finding upon googling my condition Sample finding upon googling my condition
    12. 12. “ Textbook” Stage IV, Grade 4 Renal Cell Carcinoma Illustration of Stage 4 RCC from Proleukin.com <ul><li>Details matching Dave’s case: </li></ul><ul><li>#4 matches upper right lobe lesion seen in the x-ray </li></ul><ul><li>Bone met in skull </li></ul><ul><li>Left femur turned out to have a large bone met; femur broke in May </li></ul>
    13. 13. “ Textbook” Stage IV, Grade 4 Renal Cell Carcinoma Illustration of Stage 4 RCC from Proleukin.com <ul><li>Details matching Dave’s case: </li></ul><ul><li>#4 matches upper right lobe lesion seen in the x-ray </li></ul><ul><li>Bone met in skull </li></ul><ul><li>Left femur turned out to have a large bone met; femur broke in May </li></ul><ul><li>Additional mets found: </li></ul><ul><li>both lungs, left ulna, iliac bone, and tongue </li></ul>
    14. 16. ACOR is great. I posted two messages tonight and got responses in 4 and 11 minutes. One responder also sent a private note mentioning Robin and Cathy. The other responder was Cathy. :) Through that list I've also found several other useful sites.
    15. 19. Remote Diagnosis of Wound Infection Photo of infected incision, taken by spouse and emailed to surgeon, avoiding the need for trip to Boston
    16. 20. Target Lesion 1 – Left Upper Lobe After treatment with High Dosage Interleukin-2 Baseline: 39x43 mm 50 weeks: 20x12 mm
    17. 21. Insights Gained <ul><li>Physicians must learn how to work with patients: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Provide online services </li></ul></ul><ul><ul><li>Encourage patients to use online connections </li></ul></ul>
    18. 22. Insights Gained <ul><li>Physicians must learn how to work with patients: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Provide online services </li></ul></ul><ul><ul><li>Encourage patients to use online connections </li></ul></ul><ul><li>Patients must learn to play a participatory role: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Find and use online services, especially good peer communities </li></ul></ul><ul><ul><li>Learn how to filter the good from the garbage </li></ul></ul>
    19. 23. Insights Gained <ul><li>Physicians must learn how to work with patients: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Provide online services </li></ul></ul><ul><ul><li>Encourage patients to use online connections </li></ul></ul><ul><li>Patients must learn to play a participatory role: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Find and use online services, especially good peer communities </li></ul></ul><ul><ul><li>Learn how to filter the good from the garbage </li></ul></ul><ul><li>Connected technology empowers: </li></ul><ul><ul><li>Patients </li></ul></ul><ul><ul><li>Practices/health care organizations </li></ul></ul><ul><ul><li>Providers! </li></ul></ul>
    20. 24. Insights Gained <ul><li>Physicians must learn how to work with patients: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Provide online services </li></ul></ul><ul><ul><li>Encourage patients to use online connections </li></ul></ul><ul><li>Patients must learn to play a participatory role: </li></ul><ul><ul><li>Embrace knowledge symmetry </li></ul></ul><ul><ul><li>Find and use online services, especially good peer communities </li></ul></ul><ul><ul><li>Learn how to filter the good from the garbage </li></ul></ul><ul><li>Connected technology empowers: </li></ul><ul><ul><li>Patients </li></ul></ul><ul><ul><li>Practices/health care organizations </li></ul></ul><ul><ul><li>Providers! </li></ul></ul><ul><li>“ e” transforms patient experience through health and illness </li></ul>
    21. 25. Questions? [email_address] [email_address] Please submit your evaluations!

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