Quality colloquium 2012 final

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Quality colloquium 2012 final

  1. 1. Engaging And Empowering Patients For Quality & Safety
  2. 2. “e-Patient Dave” deBronkart• High tech marketing• Data geek; tech trends; automation• 2007: Cancer kicker • 2008: E-Patient blogger • 2009: Participatory Medicine, Public Speaker • 2010: full time
  3. 3. Michael Millenson • Health Quality Advisors • Demanding Medical Excellence, Health Affairs, many more • Board of American Medical Group Foundation, AHIMA Foundation, Soc’y for Participatory Medicine Amer Jour of Medical
  4. 4. Rajni Aneja, MD, MBA, CPE • EVP, Joslin Diabetes Center • CPE / family practice • Care Continuum Alliance • ACPE • Past: – CMO for WebMD – OptumHealth nat’l medical director for disease mgmt,
  5. 5. Tom Peters, MBA, PhD • In Search of Excellence and 16 other books • Extraordinarily diverse industry experiences • Track record of successfully working with leaders to create change
  6. 6. What if Duane Smithhad a shared care plan? “e-Patient Dave” deBronkart Twitter: @ePatientDave facebook.com/ePatientDave LinkedIn.com/in/ePatientDave dave@epatientdave.com
  7. 7. Proposed taxonomy of fixes from Helen’s keynote• Putting more power in patient hands: – Information – Tools
  8. 8. Proposed taxonomy of fixes from Helen’s keynote• Putting more power in patient hands: – Information – Tools• Listening to what patients report from the front line
  9. 9. Proposed taxonomy of fixes from Helen’s keynote• Putting more power in patient hands: – Information – Tools• Listening to what patients report from the front line• Not leveraging available contributions – A squandered opportunity – Economic inefficiency
  10. 10. “It has taken a full century for the patient’s perspective to go from being routinely ignored to being hailed as a pillar of an ideal health care system.”
  11. 11. “Rethinking the relationship between the patient and professional caregivers is a cornerstone of successful health system redesign”
  12. 12. “Consumer engagement, whether in the exam room or in a health care organization’s boardroom, is a central element.”
  13. 13. “Consumer engagement, whether in the exam room or in a health care organization’s boardroom, is a central element.”I add: same forengagement atthe bedside, too.
  14. 14. Whathappened here??
  15. 15. Gawande:• A medical miracle – a great save
  16. 16. Gawande:• A medical miracle – a great save• In stark contrast, an “epic fail” with great human cost
  17. 17. Gawande:• A medical miracle – a great save• In stark contrast, an “epic fail” with great human cost• By the same people in the same system
  18. 18. What if Duane’s family had googled “splenectomy”?
  19. 19. What happened here?• Squandered potential value
  20. 20. What happened here?• Squandered potential value• An asset in the system (knowledge) that was not brought to the point of care at the time when it was needed
  21. 21. Who can solve this?
  22. 22. Who can solve this? Do we pound on clinicians more?
  23. 23. “I want to note especially the importance of the resource that is most often under-utilized in our information systems – our patients” Charles Safran MD, Beth Israel Deaconess quoting his colleague, Warner Slack MD Testimony to the House Ways & Means subcommittee on health, 2004
  24. 24. What if the care teamhad shared the care planwith the patient & family?
  25. 25. Abington Memorial created one. (It’s just an EMR report)
  26. 26. Doc Tom said, e-Patients.net founder“e-Patients are quipped E Tom Ferguson MD 1944-2006 Engaged Empowered Enabled”
  27. 27. Web 2.0: “When the web began to harnessthe intelligence of its users” – Tim O’Reilly
  28. 28. If the microscope’s happy but the patient’s not,has care been achieved? Has optimal care??Was the money well spent for customer value?
  29. 29. This is the only industry where the definition of quality doesn’t startby asking customers what they want more of
  30. 30. A patient’s definition of quality: Achieving everything we possibly can in the family member’s care.
  31. 31. Compliance
  32. 32. Compliance
  33. 33. Compliance(Whose goal is it, anyway?)
  34. 34. Compliance(Whose goal is it, anyway?) Quality???
  35. 35. EMRs and Quality (NEJM)• Patients who achieved 4 out of 5 outcomes With EMR Paper based 44% 16%• Patients whose care met four quality standards With EMR Paper based 51% 7%
  36. 36. Peter Margolis, Cincinnati Children’s .5 x .5 = .25
  37. 37. A patient’s definition of safety: Avoiding avoidable harm and mistakes.
  38. 38. A patient’s definition of safety: Avoiding avoidable harm and mistakes. Also known as accidents.
  39. 39. What could possibly stop usfrom speaking up to help?
  40. 40. Answer:We’re afraid of you.
  41. 41. “I want to note especially the importance of the resource that is most often under-utilized in our information systems – our patients” Charles Safran MD, Beth Israel Deaconess quoting his colleague, Warner Slack MD Testimony to the House Ways & Means subcommittee on health, 2004
  42. 42. “What is the Role of the Patient?”
  43. 43. “What is the Role of the Patient?”
  44. 44. “What is the Role of the Patient?”
  45. 45. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.
  46. 46. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.“There is another bell curve for costs – again, a wide gap.
  47. 47. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.“There is another bell curve for costs – again, a wide gap.“Surprisingly, the two curves do not match.
  48. 48. Gawande at CMMI Summit“There is a bell curve for quality – a wide gap between the best care and the worst.“There is another bell curve for costs – again, a wide gap.“Surprisingly, the two curves do not match.“And that means there is hope.”
  49. 49. “It has taken a full century for the patient’s perspective to go from being routinely ignored to being hailed as a pillar of an ideal health care system.”
  50. 50. Let Patients HelpHeal Healthcare. “e-Patient Dave” deBronkart Twitter: @ePatientDave facebook.com/ePatientDave LinkedIn.com/in/ePatientDave dave@epatientdave.com

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