Saturday, April 28, 2012

Scaling Care through Digital Health Coaching

Dr. Vic Strecher of the University of Michigan addresses the important topic of digital health coaching in the video below. When addressing TEDMED recently he spoke of the potential to create personalized online messages for patients to help then change their health-related behaviors. While this may not qualify as "rocket science" it is huge as our nation's healthcare delivery system becomes increasignly financed by capitation and as we try to scale up delivery of services to larger numbers of people. The bottom line in the presentation is that people are more likely to pay attention to (and act upon) highly personalized messages even if those messages were in fact computer-generated.



Additional information about Dr. Strecher is available here. http://www.ur.umich.edu/update/archives/100122/innovator

Sunday, April 15, 2012

Forgiveness, Trust and a Culture of Quality

In this video presentation, Paul F. Levy, recent CEO for the Beth Israel Deaconess Medical Center in Boston, makes a case for forgiveness in the culture of a medical institution striving for quality care. I suppose that to somehow punish a physician or other care provider for a serious mistake may be safe behavior for an administrator. People tend to admire active administrators who can make decisive decisions. But the quality of the services provided by a caregiver is more evident in the pattern of his or her work than in the exception. Physicians tend not to identify the mistakes and near-misses of others, realizing that they each are imperfect and may someday make a mistake. A culture of punishment does not promote a culture of trust, which is necessary to create continual learning and improvement.

Thursday, April 5, 2012

From social networks to social robots

At her recent TED Talk Sherry Turkle describes how she believes our electronic social and communication devices are becoming problems as we try to substitute connections for real relationships. About half way through her presentation she refers to the use of social robots in a nursing home.



I have not yet digested the relevance of her thoughts to health and administration. But I wonder if the connection (no pun intended) may be to the notion of, "patient centered care." Medical care is now team-based and individual patients sail through an entire trajectory of teams in an episode of acute care. Sooner or later someone will probably invent some charming robot that patients can carry with them through the experience and perhaps even carry home with them. It will be programmed to help the patient understand what is happening to them now and why. It may even become the repository of some data useful to medical caregivers along the way and may monitor the patient's vital signs. Those of us who remember the joys of early social technology in the era when Turkle wrote her book Life on the Screen remember fascination with live online communications. The very idea that a computer could reproduce the sound of a baby's cry or the gesture of person on the other side of the earth was exciting.

Now I observe my students who almost always have their mobile telephones in hand. I share a concern that we may be losing more than we are gaining. If someday I slowly walk or roll the corridors of a nursing home I want good meals and broadband internet access! But I hope for myself and others for more than a cute robot to talk to as I reflect upon life and circumstances. The healthcare delivery system is not friendship service. But I do believe that "patient centered" is about being person centered and that we may have used the phrase, "patient centered" to gloss a dimension that cannot scale through technology or process design.