The document discusses how individuals will provide less clinical information if they believe it could be used against them as a "weapon". It uses the parable of being asked to provide a stick to beat oneself with versus providing a stick to beat a common enemy like a disease. When the goal is common, individuals will freely share more complete, timely, and trustworthy personal information to aid effective decision making.

1. THE PARABLE OF THE STICK Copyright HeartCloud Inc. 2013
The Parable of the Stick ©
By: Thomas A. Coss, RN
ssume for a moment that you and I are to engage in a business
arrangement in which your role is to beat me about the head and
shoulders with a stick. My role in this arrangement is to provide you
the stick. So how big a stick might you expect?
From my perspective, a No.2 pencil would meet the requirement perfectly.
The worst that will happen to me is that I would be annoyed while you are likely to get exhausted.
This is the situation in which healthcare finds itself with respect to clinical information. When
individuals believe information they provide will be used against them as a weapon, they provide less
of it - a “smaller stick”.
Capturing remote data and information from people is a brittle task, highly susceptible to breakage if
misused. The professional and ethical regard for information willingly shared by patients requires
conscious effort well beyond the naive conventions of HIPAA, to include protections against the use
of information that can be destructive or shaming. Any misuse of candid, trustworthy information,
regardless of reason, imposes expense burdens and hazards that must to be avoided in order to
reduce healthcare costs while improving the quality of life.
Information itself plays no favorites, has no opinions and imposes no risks; information is essentially
inert, benign and indifferent to its consumption. Humans are the only ones capable of applying
interpretation, meaning and biases; we are the only ones who can turn information into a weapon,
but not forever. Once information, which had been surrendered willingly and in good faith, is misused
it is difficult to go back; the channel closes and may never re-open. No one will willingly shares
information if they believe it will later be used against them like a weapon.
Returning to our business arrangement, suppose we alter one thing. This time
I am being asked to provide you with a stick with which you and I will beat a
common enemy, perhaps it’s my cancer, heart disease, hypertension, obesity
or diabetes. This time I’m all in and I will get the biggest stick (information) you
can handle.
Now information flows freely. It comes to you well organized, easy for you to
consume, and with perspective so that it is meaningful and clear. With a common goal you receive
personal information that is accurate, relevant, trustworthy and timely - upon which decisions can be
made and effective actions taken.
What is changing is that clinical information no longer exists just inside the hospital, it comes from the
home, and shared with family members, clinicians and friends who care and who matter.
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