I am a person, not an object

The NY Times seems to be on a roll with health care stories. This morning they have an article about what often happens when people make the transformation from citizen to patient upon entering a hospital. Even in well-run, well-intentioned hospitals the experience can be dehumanizing. This is not a new phenomenon by any means. But it can be an added burden when you’re seriously sick.

Where to turn?

This morning’s NY Times has a fascinating article about the difficulties people with serious illnesses are having with the overwhelming amount of information that is available to them and about how uncomfortable they are making the choices they often face as "autonomous" decision makers. The article starts with the experience of a woman with ovarian cancer. When given differing suggestions about treatment by physicians and told she would have to choose whether or not to try a therapy that was experimental at the time, she asked:

"Who will decide?" she asked a surgeon from Los Angeles.

The doctor then recited what has become the maddening litany of medical
correctness: "We’re in the outer regions of medical knowledge," he said, "and
none of us knows what you should do. So you have to make the decision, based on
your values."

Ms. Gaines, bald, tumor-ridden and exhausted from chemotherapy, was reeling.
"I’m not a doctor!" she shouted. "I’m a criminal defense lawyer! How am I
supposed to know?"

This is the blessing and the burden of being a modern patient. A generation
ago, patients argued for more information, more choice and more say about
treatment. To a great extent, that is exactly what they have received: a
superabundance of information, often several treatment options and the right to
choose among them.

As this new responsibility dawns on patients, some embrace it with a sense of
pride and furious determination. But many find the job of being a modern
patient, with its slog through medical uncertainty, to be lonely, frightening
and overwhelming.

The article has many stories. It also gives some history on the changes in health care thinking that have led to this situation. Perhaps it also gives some hints about why the public and news media seem to be so skeptical and cynical about medical news these days. The story provides a good argument for patient navigation. There seems little doubt we’ll all need it sometime.

New move in e-health records

The NY Times reports that Medicare is going to give away to doctors record-keeping software that’s been used by Medicare and the VA for years. A couple of years ago the Bush Admin. set up a project to set some industry standards for EMR, but evidently that didn’t go anywhere. Now Medicare is just going to put it out there. The database industry players may have blown it. In holding out for their product to dominate the market they may have to deal with the Medicare software as a defacto standard, a kind of government sponsored open source.

Medicare, which says the lack of electronic records is one of the
biggest impediments to improving health care, has decided to step in.
In an unprecedented move, it said it planned to announce that it would
give doctors – free of charge – software to computerize their medical
practices. An office with five doctors could save more than $100,000 by
choosing the Medicare software rather than buying software from a
private company, officials say.

Revolution plans health information

Another note on Steve Case’s Revolution Health Group as he releases more information on his plans.

This week he posted a news release on Business Wire that says the RHG has reached preliminary or final agreements with seven companies, with initial areas of focus including:

Convenient Care. RHG will bring affordable, convenient, nurse-provided care to retail locations all across the country.

Health Information. RHG will provide consumers the very best information to help them find a doctor or other health care provider, and to learn more about medical issues and conditions.

Managing Health Finances. RHG will provide consumers with tools to help them manage their health care finances, as well as provide small and mid-sized employers tools to help them help their employees.

Personal Health Records. RHG will provide consumers with secure, easy-to-use personal health records.

Health Care Coverage. RHG will offer consumers new choices in how to pay for their health care.

Without more information at this point, it is hard to assess opportunities for the Society, but it is clear Case intends to make maximum impact including in the areas of health information and personal health records. Case says more details are coming "in the Fall, after the transactions have obtained all necessary legal and regulatory approvals."