connected health & me - epatient dave - nov 24th 2014

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“e-Patient Dave” deBronkart Twitter: @ePatientDave facebook.com/ePatientDave LinkedIn.com/in/ePatientDave [email protected] People Perform Better When They’re Informed Better 1

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“e-Patient Dave” deBronkart

Twitter: @ePatientDave

facebook.com/ePatientDave

LinkedIn.com/in/ePatientDave

[email protected]

People Perform Better

When They’re

Informed Better

1

“It can be argued

that the largest

yet most neglected

health care resource,

worldwide,

is the patient…”

e-Patients.net founder

Tom Ferguson MD1944-2006

Equipped

Engaged

Empowered

Enabled

e-Patients are

Me? An indicator of the future??

• Who’s getting online:– 1989: Me (CompuServe sysop)

– 2009: 76% of US adults (Pew)

• Who’s romancing online:– 1999: I met my wife (Match.com)

– 2009: One in eight weddings

in the U.S. met online

– 2011: One in five couples

met online

The Incidental FindingRoutine shoulder x-ray, Jan. 2, 2007

“Your shoulderwill be fine …but there's something in your lung”

Multiple tumors in both lungs Where’s This From??

Classic

Stage IV,

Grade 4

Renal Cell

Carcinoma

Illustration on

the drug company's

web site

Median Survival:

24 weeks

After the shock

you’re left with the question:

What are my options?

What can I do?

Get engaged.

Get it in gear.

Do everything you can.

E-Patient Activity 2:

“My doctor prescribed ACOR”(Community of my patient peers)

ACOR members told me:

• This is an uncommon disease –

get to a hospital that does a lot of cases

• There’s no cure, but HDIL-2 sometimes works.– When it does, about half the time it’s permanent

– The side effects are severe.

• Don’t let them give you anything else first

• Here are four doctors in your area who do it– And one of them was at my hospital

Surgery & Interleukin worked.Target Lesion 1 – Left Upper Lobe

Baseline: 39x43 mm 50 weeks: 20x12 mm

Question:

How can it be

that the most useful

and relevant and

up-to-the-minute information

can exist outside of

traditional channels?

Because of the Web,

Patients Can Connect to Information

and Each Other (and other Providers)

“If I read two journal articles every night,

at the end of a year I’d be 400 years behind.”

It’s not humanly possible to keep up.

Dr. Lindberg: 400 years

The lethal lag time: 2-5 years

During this time,

people who might have benefitted can die.

Patients have all the time in the world

to look for such things.

The time it takes after successful research is completed

before publication is completed and the article’s been read.

Compare with

“To Err is Human” (98,000 deaths/yr Nov 1999)

Death by Googling:Not.(Dr. Gunther Eysenbach, Europe: 0 deaths found in a three year search)

“It may be

more dangerous

not to google

your condition.”

“These conclusions

are no more anti-doctor

or anti-medicine

than Copernicus and Galileo

were anti-astronomer.”

Patients can simply contribute

more today than in the past.

Zoe

When does

autonomy

become

appropriate?

“How can patients participate if they can’t

see what I see?” – Dr. Danny Sands

What happens when patients see

their doctors’ notes?

• 99% of patients wanted to continue

• 17-26% of docs preferred not to…– But when given the chance to stop, none

did

• 85-89% of patients said availability of

open notes would influence their

choice of providers and health plans

Urgency:

The Demographic

Crunch

Half of everyone who’s ever been 65 is alive today

Population today: ~7.0 billion

End of World War II: ~2.3 billion

My classmate Jay

What if

the data

in the system

is wrong?

Your mother’s physicians

cannot perform

to the of their ability

Your mother’s physicians

cannot perform

to the top of their ability

if the facts they’re given

are wrong

Who has the most at stake

with the accuracy,

completeness and

availability

of the medical record?

Please:

LetPatients

Help.

Wil l iam Gibson

“The future

is here –

it’s just

not evenly

distributed yet”

“e-Patient Dave” deBronkart

Twitter: @ePatientDave

facebook.com/ePatientDave

LinkedIn.com/in/ePatientDave

[email protected]

People Perform Better

When They’re

Informed Better

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