presentation to merrimack valley section of american society for quality
TRANSCRIPT
“e-Patient Dave” deBronkartTwitter: @ePatientDave
facebook.com/ePatientDaveLinkedIn.com/in/[email protected]
e-Patients: Engaged, Empowered, Equipped, Enabled“Patient” is not a third person word
How I came to be here• High tech marketing• Data geek; tech trends; automation• 2007: Cancer discovery & recovery
• 2008: E-Patient blogger• 2009: Participatory Medicine,
Public Speaker• 2010: full time• 2011: international
Two emerging changes
1. Technological evolution of what’s possibleenabled by IT
2. Sociological change: the “emancipation” of autonomous patients
“Patients are the most under-used resource in healthcare”
Informatics pioneer Dr. Warner Slack,since the 1970s
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This evening, bear in mind1. Think about everything you hearwith YOU as the customer/patient.
What will you do?
2. How can we bring ASQ thinkingto the healthcare industry?
(especially overcoming foot-dragging)
“Patient” is not a third-person word.
Your time will come.
Always, always think how you will feel when it’s your child or your parent whose life is at stake
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And, we are – you are –the ultimate stakeholder
Who else hasmore “at stake”
in how well healthcare works?
Yet we’re often excluded from talks with
“all stakeholders”
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e-Patients.net founderTom Ferguson MD1944-2006
EquippedEngagedEmpoweredEnabled”
Doc Tom said,“e-Patients are
Me? An indicator of the future??
• Who’s getting online:– 1989: Me (CompuServe sysop)– 2009: 83% 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
2007: My “Incidental Finding”Routine shoulder x-ray, Jan. 2, 2007
“Yourshoulderwillbefine…butthere'ssomethinginyourlung”
Classic Stage IV, Grade 4
Renal Cell Carcinoma
Illustration on the drug company’s
web site
Median Survival:24 weeks
My patient peers 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
How can it be
that the most usefuland relevant and
up-to-the-minute information can exist outside of
traditional channels?
Donald Lindberg MDDirector of the National Library of Medicine
“If I read two journal articles every night, at the end of a year I’d be 400 years behind.” (2004)
2012: • 2,200 articles / day• 10,000 conditions• Patients can focus on
just their disease.
The lethal lag time: 2-5 years
During this time, people who might have benefitted can die.
Patients have all the time in the worldto look for such things.
The time it takes after successful research is completedbefore 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)
Closed system Open network
Transformation of Knowledge Access
Slide by @ePatientDave 2015Based on Engelen & Derksen, 2010
Adoption of new practices years after discoveryThe “17 years” thingFrom A. Balas, Institute of Medicine, in Yearbook of Medical Informatics 2000
Flu vaccine, year 32: 55% doing it, 45% still not
Beta blockers, year 18: 62% doing it, 38% still not
Diabetic foot care, year 7: 20% doing it, 80% still not
Cholesterol, year 16: 65% doing it, 35% still not
Creative Commons Attribution / Share-AlikeMay be distributed with this license included
Not liquid Liquid• Moving it takes effort
• Slow and predictable
• Arrivals on unexplained “tracks” are suspicious
• Frictionless – controllingthe flow takes effort
• Fast and unpredictable
• “Tracks” everywhere, free
“A new scientific truth does not triumph by convincing its opponentsand making them see the light,
Max Planck Nobel Prize, 1918
“A new scientific truth does not triumph by convincing its opponentsand making them see the light, but rather because its opponents eventually die,
Max Planck Nobel Prize, 1918
“A new scientific truth does not triumph by convincing its opponentsand making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”
Max Planck Nobel Prize, 1918
“e-Patient Dave” deBronkartTwitter: @ePatientDave
facebook.com/ePatientDaveLinkedIn.com/in/[email protected]
e-Patients: Engaged, Empowered, Equipped, Enabled“Patient” is not a third person word