quality colloquium 2012 final

Engaging And Empowering

Patients For Quality

& Safety

“e-Patient Dave” deBronkart

• High tech marketing• Data geek; tech trends; automation• 2007: Cancer kicker

• 2008: E-Patient blogger

• 2009: ParticipatoryMedicine, Public Speaker

• 2010: full time

• 2011: international

• 2012: turning the corner

Michael Millenson• Health Quality

Advisors

• Demanding Medical Excellence, Health Affairs, many more

• Board of American Medical Group Foundation, AHIMA Foundation, Soc’y for Participatory Medicine Amer Jour of Medical Quality

Rajni Aneja, MD, MBA, CPE• EVP, Joslin Diabetes

Center

• CPE / family practice

• Care Continuum Alliance

• ACPE

• Past:– CMO for WebMD– OptumHealth nat’l

medical director for disease mgmt, quality & standards

Tom Peters, MBA, PhD

• In Search of Excellence and 16 other books

• Extraordinarily diverse industry experiences

• Track record of successfully working with leaders to create change

“e-Patient Dave” deBronkart

Twitter: @ePatientDavefacebook.com/ePatientDave

LinkedIn.com/in/ePatientDavedave@epatientdave.com

What if Duane Smith had a shared care

plan?

Proposed taxonomy of fixes

from Helen’s keynote• Putting more power in patient

hands: – Information– Tools

Proposed taxonomy of fixes

from Helen’s keynote• Putting more power in patient

hands: – Information– Tools

• Listening to what patients report from the front line

Proposed taxonomy of fixes

from Helen’s keynote• Putting more power in patient

hands: – Information– Tools

• Listening to what patients report from the front line

• Not leveraging available contributions– A squandered opportunity– Economic inefficiency

“It has taken a full century for the patient’s perspective to go from being routinely ignored to being hailed as a pillar of an ideal health care system.”

“Rethinking the relationship between the patient and professional caregivers is a cornerstone of successful health system redesign”

“Consumer engagement, whether in the exam room or in a health care organization’s boardroom, is a central element.”

“Consumer engagement, whether in the exam room or in a health care organization’s boardroom, is a central element.”

I add: same for engagement at

the bedside, too.

What happened

here??

Gawande:

• A medical miracle – a great save

Gawande:

• A medical miracle – a great save

• In stark contrast, an “epic fail”with great human cost

Gawande:

• A medical miracle – a great save

• In stark contrast, an “epic fail”with great human cost

• By the same people in the same system

What if Duane’s familyhad googled

“splenectomy”?

What happened here?

• Squandered potential value

What happened here?

• Squandered potential value

• An asset in the system (knowledge) that was not brought to the point of care at the time when it was needed

Who can solve this?

Who can solve this?

Do we pound onclinicians more?

“I want to note especially the importance of the

resource that is most often under-utilized in our information systems – our patients”

Charles Safran MD, Beth Israel Deaconess quoting his colleague, Warner Slack MDTestimony to the House Ways & Means subcommittee on health, 2004

What if the care teamhad shared the care

planwith the patient &

family?

Abington Memorial created one.

(It’s just an EMR report)

e-Patients.net founderTom Ferguson MD 1944-2006

Equipped

Engaged

Empowered

Enabled”

Doc Tom said,

“e-Patients are

Web 2.0: “When the web began to harness the intelligence of its users” – Tim O’Reilly

If the microscope’s happy

but the patient’s not,

has care been achieved?

Has optimal care??

Was the money well spentfor customer value?

This is the only industrywhere the definition of

qualitydoesn’t start

by asking customers what they want more of

A patient’s definition of quality:

Achieving everythingwe possibly can

in the family member’s care.

Compliance

ComplianceAchieveme

nt

Compliance(Whose goal is it, anyway?)

Achieveme

nt

Compliance(Whose goal is it, anyway?)

Achieveme

nt

Quality???

EMRs and Quality (NEJM)

• Patients who achieved 4 out of 5 outcomes

With EMR Paper based 44% 16%

• Patients whose care met four quality standards

With EMR Paper based 51% 7%

Peter Margolis, Cincinnati Children’s

.5 x .5 = .25

A patient’s definition of safety:

Avoiding avoidableharm and mistakes.

A patient’s definition of safety:

Avoiding avoidableharm and mistakes.

Also known as accidents.

What could possiblystop us

from speaking up to help?

Answer:We’re afraid of you.

“I want to note especially the importance of the

resource that is most often under-utilized in our information systems – our patients”

Charles Safran MD, Beth Israel Deaconess quoting his colleague, Warner Slack MDTestimony to the House Ways & Means subcommittee on health, 2004

“What is the Role of the Patient?”

“What is the Role of the Patient?”

“What is the Role of the Patient?”

Gawande at CMMI Summit

“There is a bell curve for quality – a wide gap between the best care and the worst.

Gawande at CMMI Summit

“There is a bell curve for quality – a wide gap between the best care and the worst.

“There is another bell curve for costs – again, a wide gap.

Gawande at CMMI Summit

“There is a bell curve for quality – a wide gap between the best care and the worst.

“There is another bell curve for costs – again, a wide gap.

“Surprisingly, the two curves do not match.

Gawande at CMMI Summit

“There is a bell curve for quality – a wide gap between the best care and the worst.

“There is another bell curve for costs – again, a wide gap.

“Surprisingly, the two curves do not match.

“And that means there is hope.”

“It has taken a full century for the patient’s perspective to go from being routinely ignored to being hailed as a pillar of an ideal health care system.”

“e-Patient Dave” deBronkart

Twitter: @ePatientDavefacebook.com/ePatientDave

LinkedIn.com/in/ePatientDavedave@epatientdave.com

Let Patients HelpHeal Healthcare.