When confronted by Powerpoint detractors I usually scratch my head and wonder why so many blame the messenger. Steven Pinker said it most succinctly...
"If anything, Powerpoint, if used well, would ideally reflect the way we think."
If you still don't believe me let me introduce you to the antidote for the infamous "Death By Powerpoint." If you have the opportunity to attend a Pecha Kucha night you will instantaneously become a convert. Imagine high energy dynamic presentations replacing data dumping and not so hidden business agendas within our industry.
The format limits unnecessary content and yields a focused and intimate discourse. The ability to ramble is curtailed by the strict sub-7 minute length.
The biggest challenge is learning how to pronounce Pecha Kucha as you will hear it massacred every where you turn. The closest I can get you without whispering in your ear is to have you imagine it as 4 syllables--pe cha ku cha with the same emphasis on each syllable. That will get you pretty close.
This brings me to PAT. I introduced PAT at a meeting earlier this year where I presented on value--what it is and how to measure it. I am in the process of editing the audio but will happily share it with you here once it is done.
The basic premise aligns with the simplicity and power of a TED talk. Technology, entertainment, and design. Not to geek out but can you envision a global community creating a deeper and sincere understanding of healthcare and medicine? Ideas are powerful facilitators of change and help converge inspired thinkers behind a significant purpose.
PAT patient centricity + adherence + technology is a toe in the water of inviting others to engage in more thoughtful engagement. What is missing from the ongoing narrative is connection from the podium. We have all been in conferences that seem to be endless. Speakers overcome with nerves, lack of preparation, horrible slides, and worse of all--limited integrity.
And then, out of seemingly a void, a real dynamic presenter approaches the podium. We lean in to listen as we hear a message that brings value to our everyday and maybe even challenges what we previously knew to be true. We need moments like these with the challenges facing healthcare. When we create our presentations we need to speak from the intersection of health policy, economics, and clinical medicine. We can't afford the business model of "verticals" any longer.
When I review content I see a common theme. Scientifically robust content that although accurate and informative is the visual equivalent of covering our ears and humming to avoid the reality that surrounds us. In the absence of context within the health ecosystem, there is limited relevance to the practice of medicine.
I would like to invite you to participate in the "brain trust" of authentic discourse that has the power to transform our industry. I witnessed the possibility after attending the Lown Conference in San Diego. Not that many slides, but a lot of passion and sleeve rolling to bring something meaningful to the table.
Its time to create meaningful and valuable presentations.
Do you want us to save you a chair?
Imagine a healthcare system that is absolutely remarkable. Patients feel well cared for, and receive the care they need, no more and no less. Imagine a gathering of committed, passionate, and skilled physicians, health care workers and advocates who won’t stop until they make that system real.--Lown Institute
I am a big fan of storytelling. Listening to TED radio podcast during long runs pretty much drives my curiosity and creativity for the writing process. The show today opened with audio of crackling and scratching and we discover Deborah describing tiny microphones picking up sound as the ants walk across. Here is Deborah's 2014 TED talk.
A recent NY times article, The Tangle of Coordinated Health Care presents the complexity of managing patients with chronic and complex care needs. Although typically considered an unmet need in elderly populations the responsibility for continuity of care falls on each of us individually when we meet the firewall of healthcare data silos that lack a coordinated interphase. Incompatibility of data systems complicates the efficient exchange of informatics. Are we putting too much of a burden on the patient for oversight of their care?
Patients managing multi-morbidity or chronic specialized care frequently access their healthcare from different providers in a variety of health settings. Unfortunately these systems of care aren't necessarily communicating updates or outcomes of the full cycle of care outside of their walls. Moving forward, reimbursement and value determination will rely on medical outputs to provide qualitative and quantitative insights beyond the fading "fee-for-service model. Where are the input channels or nodes for data corresponding to the entire arc of treatment and patient management?
More specifically, who coordinates the proliferating number of health care helpers variously known as case managers, care managers, care coordinators, patient navigators or facilitators, health coaches or even — here’s a new one — “pathfinders”?
Clearly the US healthcare system remains fragmented. Specialists work in silos and lack prescription history or even real-time updates of ongoing care in the context of episodic disease management. I am reminded of the three stooges in their Who is on First skit.
In the absence of significant health informatics reform, the patient is the conduit for relaying information--in my opinion that is truly a heavy burden. Especially if you consider that the radio silence between stakeholders often stems from the paywall or monetization of data access.
Click here for access to a guide for finding free healthcare data for analyses...
Research has shown an association between obesity and increased risk for many cancers. Although additional research is ongoing the relationship between weight loss and cancer risk is limited. Preliminary studies do suggest that weight loss may reduce the risk of certain cancers.
Economics of Obesity
Research to evaluate cost-effective interventions that address obesity are shown in the figure. ACE interventions are mapped to a continuum of key determinants and solutions to the obesity epidemic.
Upstream factors related to economic systems to downstream factors affecting the physiology of individuals highlight three preventive interventions that targeted the obesogenic environment (reduction of advertising of unhealthy food and beverages to children, front-of-pack traffic light nutrition labelling and a 10% tax on unhealthy food and beverages) were all cost-saving. Associated with potentially difficult political support or integration many of these strategies are not likely to be implemented.
This figure represents the link between society based solutions and measures directed at individual behavior and outcomes. The balance of non-pharmacologic intervention and potential pharmacologic solutions are an important highlight of the studies as we strive to manage the risk factors that continue to drive escalating healthcare costs.
The image of a "natural death," a death which comes under medical care and finds us in good health and old age, is a quite recent ideal. In five hundred years it has evolved through five distinct stages, and is now ready for a sixth. Each stage has found its iconographic expression:
(1) the fifteenth-century "dance of the dead";
(2) the Renaissance dance at the bidding of the skeleton, the so-called "Dance of Death";
(3) the bedroom scene of the aging lecher under the Ancien Régime;
(4) the nineteenth-century doctor in his struggle against the roaming phantoms of consumption and pestilence;
(5) the mid-twentieth-century doctor who steps between the patient and his death; and
(6) death under intensive hospital care. At each stage of its evolution the image of natural death has elicited a new set of responses that increasingly acquired a medical character.
The history of natural death is the history of the medicalization of the struggle against death.
Pharma spends more on advertising than on R&D
Let me first remind you of the amount of spend dedicated to sales and marketing within big pharma. Can you recall any personal narrative stories that have resonated or captured the humanity of the consumers of our trillion dollar healthcare industry?
When I think of the industry messages that are directed to me the consumer what I actually can remember consists of the Abilify cartoon being followed by a little dark cloud of depression that persists no matter how hard she tries to manage her symptoms. Or the erectile dsyfunction/sexual dysfunction adds that warn of a persistent potential 4-hour sustained effect and a myriad of other risks while a couple holds hands across two individual claw foot tubs--hint: perhaps you might want to be in the same tub?
A popular post in Linkedin introduced many of you to Seth Godin. His narrative voice resonates with me and has influenced much of what I believe about client engagement. Seth writes about the "post-industrial revolution, the way ideas spread, marketing, quitting, leadership and most of all, changing everything." The concept that he introduced to my lexicon and millions of others is that of a "tribe". All a tribe needs is a shared message and a communication strategy to dramatically change the way business is done within a certain industry.
Day in the Life: Managing your Diabetes Diagnosis
I will show you my data if you show me yours
When making decisions about effective content strategies I notice that many stakeholders are leaving "data" on the table. I certainly understand that nothing about BIG data and all of its promises sounds easy or accessible. In my work as an insight analyst I have found a lot of relevant types of data that can help funnel the "noise" and help you avoid low-value data. In this digital age there isn't any value in pulling data out of published reports to identify knowledge gaps or to direct content needs. Here are a few insights below with the caveat that I am working on a more "hands on" guide to level set any organizations that are committed to leveraging available data to inform communication strategies, funding opportunities, or medical education content. But first, we have to sharpen our axe...
McKinsey and Company compiled a report that identified the 4 main sources of healthcare data.
Utilization rates and unit cost data
These figures represent the amount of care supplied by healthcare systems or providers and the cost per member per month-pmpm (or per year) reflecting the cost of the care dispensed. Often I am asked to analyze 3rd party insurance data and initially I was surprised at how the findings weren't at all what I expected. Where were all of the costs for cardiovascular disease and cancer care? The number 1 cost pmpm in many of the systems that I reviewed were orthopedic and musculoskeletal disorders.
Patient medical records especially in EHR/EMR systems are a valuable source of compliance and outcomes data for practices able to leverage the metrics and optimize their integration. National Association of Healthcare Organizations or NAHO is a good place to start looking for sources of patient level data that are often accessible.
Pharmaceutical R&D data
Clinicaltrials.gov and many proprietary registries and pharmaceutical company partnerships yield large databases available for a fee. The ability to view clinical trial data and interim data findings can be informative and direct pipeline decisions and updates.
Patient behavior data
Think business units by CVS and other drugstore chains that leverage data from over-the-counter drug sales combined with the latest “wearables” technology that is only just developing but hints at a large market with Apple entering the tech space.
Now, make me care...
Person-centered measures need to integrate with current screening guidelines to determine relevant risk factors for breast cancer screening. Advance age, genetic profile, obesity, breast density, and family history of breast disease or cancer should be carefully selected considerations for screening. Sometimes First Do No Harm means first do nothing...
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I am a medical/health economics writer/ data analyst, ultra-runner, and mom.
It isn't enough to label everything evidence-based and consider it business as usual.
Question the quality of the evidence. The motivation for disseminating the evidence.
Who stands to benefit the most from its uptake?
Remember the quote by Upton Sinclair...
“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”