"Stop Blaming the Patient!"

From MedCityNews.com: "Mayo doc: Stop blaming patients. Healthcare industry’s take on non-compliance is all wrong."

Dr. Victor Montori offers some great riffs on engagement:

Non-compliance is frequently talked about as a cost and a burden put on the healthcare system by patients. But Montori’s theory is that really, it’s the healthcare system over-burdening the patient.

“We have to be very careful not to blame the patients,” Montori said during his closing keynote at MedCity’s ENGAGE on Thursday. “A lot of the conversation (around patient engagement) has been, how do we get them to do stuff? To me, that’s not engagement."

[...]

Montori closed by asserting that the U.S. healthcare system will be the best in the world only when it begins to shrink. “Healthcare right now is all about itself. Healthcare right now is about how do we get bigger, more market share,” he said. “That means that patients have to take more medicine, have to monitor themselves more often [...] We will have the best healthcare system in the world when it becomes the first healthcare system that shrinks.”

9:23 AM

Tensions In Innovation, 2013

Forbes:  "...it’s hard not to worry that if medicine goes in the direction of the Cheesecake Factory, where care is administered on the cheap by customer-service technologists plugging data into an algorithm, then an ancient and noble profession will face extinction because of an inability (some might say a haughty unwillingness) to adequately contemplate and communicate its essential value proposition." 

1:33 PM

Rating 7.7 Million Meals To Learn...

...that we think pizza is WAY healthier than it really is! From Massive Health (via Forbes Magazine): "Massive Health Analyzes 1/2 Million Meals to Understand Our Eating Habits [Infographics]."

"Over the past 5 months, Massive Health has collected over 7.68 million food ratings from people in 50 countries through The Eatery, an iPhone app that helps users track and analyze their eating patterns. Today, they are releasing some of their key findings about when people eat, where people eat, what they eat, and who they eat with, as a series of infographics. For more information about the company and to see the infographic detailing at how people think they eat (and how healthy they actually eat) click here.

"Key Finding on When We Eat

• We eat 1.7 percent less healthy after each hour that passes in the day
• Breakfast is the healthiest meal of the day. Dinner is 15.9 percent less healthy
• People who eat breakfast eat 12.3 percent healthier during the day
• On the weekend, we eat more unhealthy foods – including 1.4 times as many croissants and 1.6 times as much beer."

Can this self-reported 'crowdsourced' data be trusted? More, here, from foodandtechconnect.com:

"Collecting large-scale, real-time data about people’s diets, not just self-reported details about their eating habits, is nearly impossible. Yet, this data could help us and the medical community better address the rising obesity and diabetes epidemics. Over the past 5 months, Massive Health has collected over 7.68 million food ratings from people in 50 countries. Today, they are releasing some of their key findings about how people think they eat (and how healthy they actually eat), where people eat, what they eat, when they eat, and who they eat with, as a series of infographics.

“Famously, one of the most accurate ways to guess the number of jellybeans in a jar is to average the guesses of everyone in the room,” writes Massive Health co-founder and CTO Aza Raskin on the company blog. “The crowd-sourced method beats much more advanced algorithms. To test our hunch that the same applied in nutrition, we looked at the aggregate Eatery scores for all meals eaten in a city versus the published obesity level in that city. It turns out there’s a strong correlation. Eatery data can accurately predict obesity levels of cities in the United States. That is, Eatery data strongly correlates with the healthiness of its users.”

Now pardon me while I eat some oatmeal.

1:52 PM

Diabesity: What if our best practices are the wrong practices?

The Daily Beast:   "...what if we are coordinating the wrong kind of care? What if our best practices are the wrong practices? Our toxic industrial diet, our sedentary lifestyle, chronic stress, and environmental toxins cause diabesity and its attendant downstream ills (often mislabeled as something else, such as hypertension, cancer, heart disease, dementia). Drugs and surgery are feeble, ineffective, costly, and often harmful treatments for lifestyle-induced illness. They are misguided efforts at best, dangerous at worst. Mounting evidence proves that the solution to lifestyle- and diet-driven obesity-related illnesses won’t be found at the bottom of a prescription bottle; they will be found at the end of our fork."

[...]

"Health it seems happens outside the clinic, where people live, work, play and pray. We need to rethink how we treat chronic disease. It is not only better medical management, which often just barely if at all staves off complications and death, but with high science, low cost, high touch innovations. A comprehensive integrated strategy can solve this problem. Start with revised screening guidelines to identify the 90% of pre-diabetics and the 25% of diabetics never diagnosed. Build new practice models and reimbursement for group visits to deliver lifestyle medicine in more effective and cost efficient ways. Support and scale proven community-based peer-support models of lifestyle change. Over 20% of Americans are out of work. Train a new army of 1 million community health workers like the barefoot doctors of China who can support their peers in creating health. Set a national goal for America of losing 1 billion pounds in a year."
Read the whole thing.  Then go outside and get some exercise!

6:44 AM

Ford seeks to develop "the car that cares."

From PhysOrg.com:  Ford, Microsoft Corp. and Healthrageous are researching how connected devices can help people monitor and maintain health and wellness.
"According to a study conducted by Pew Research:

• 93 percent said they seek out online health information because it's convenient - they want to get information on their own timetable, not the doctor's.
• 83 percent said it's because they can get more information from the Web than they can get from their own doctor.
• 80 percent said getting this information privately is important to them.

"As people spend more time in their cars, the ability to manage health and wellness on the go becomes more important. There are several reasons why the automobile is an ideal platform for research and development in this area:

• It's convenient and private.
• It facilitates personalized access to the information, products and services people need.
• And it's a logical place for them to manage their health while they are more often stuck in traffic.

"The goal is to figure out how to extend health management into the personal vehicle in a nonintrusive fashion. The prototype system was designed by BlueMetal Architects."

[Read more...]

.

3:13 PM

The Doctor In Your Car

Ford Exec To Keynote Digital Health Event At CES: Gary Strumolo, global manager of health, wellness, interiors and infotainment for Ford Research and Innovation will be the day one luncheon keynote speaker for the Digital Health Summit at the 2012 International CES.

From the article:

"Just as mobile has enabled Americans to take a more active role in managing their health and well-being, automobile manufacturers like Ford are looking to develop a series of health and wellness in-car connectivity solutions designed to empower people with self-help information while they drive," said Jill Gilbert, co-producer, Digital Health Summit. "As the most progressive automobile brand in the health space, Ford has both the credibility and expertise to share insights on next generation innovations around consumer oriented health and wellness solutions on the go."



"Leveraging the Ford Sync connectivity platform and its ability to connect to mobile devices via Bluetooth, access cloud-based Internet services and control smartphone apps via voice recognition, Ford - collaborating with WellDoc, SDI Health and Medtronic - developed industry-first, voice-controlled health and wellness in-car connectivity solutions that include alerting diabetics to glucose levels through audio alerts, an allergy alert app providing location-based index levels for pollen, and health management services while on-the-go."

Interesting.  Watch where this trend goes.

6:24 AM

Thomas Goetz: It's time to redesign medical data

11:43 AM

Your Next Health Coach May Be...

...your car.  From Edmunds Inside Line:

"Ford cars and trucks may soon be able to tell you when to take a puff on your asthma inhaler or test your blood glucose level, as the Dearborn automaker is poised to take its Sync communications system far beyond infotainment.

"The Dearborn automaker offered a tantalizing — if somewhat disconcerting — look on Wednesday at the potential for a vehicle to be your partner and coach when it comes to health and wellness.

"Ford said it was intent on demonstrating a paradigm shift in the way its Sync communications system is used. In the not-too-distant future, a car could let you know the UV index so you could apply the proper amount of sunscreen, monitor your food choices at McDonald's, or check your calendar to see whether you'll be playing sports that day and may need an extra puff or two on your asthma inhaler.

'"We're not trying to turn the car into a medical device," said Alan Hall, a Ford spokesman in a phone conversation with Inside Line. "We're a conduit for healthcare to become mobile."'

As they roll out their own health coaching strategies, do physicians and hospitals see Ford as competition? Maybe they should. And I'll bet Ford gets there first. 

Actually, turning the car into a medical device is fine with me. I'd much rather deal with my mechanic than my HMO or some clinic's wretched appointment scheduling system.  My mechanic only charges an arm and ONE leg.

7:32 AM

Smoking Kills and I've the Game To Prove It!

I thought I'd add something to the post below about ideas.  Here's one to get you started, from a student of mine in last semester's "Materialism and Idealism" class:

Patients often need prodding to learn about disease and the behavioral and lifestyle changes necessary to live healthier lives.  Yet the same people often play video games willingly and exuberantly.   No prodding necessary.  What if...you combined the two - the teaching and the game playing - into a fun, challenging yet subtly educational game?

Example:    Create a video game where the combat hero's years of heavy smoking induces coughing fits that reveal his platoon's position to the enemy.  

Bam!  Dead platoon.  

Game over.

Smoking kills. 

Lesson learned.

No need to carry around a jar full of diseased lungs bathed in formaldehyde.  No more 8th graders chuckling in the back row.

11:17 AM