DOCtalk by Dr. Gregg 12/24/11

The Year’s Biggest HIT Event May Be a Sneaker

Over on granddaddy HIStalk, you’ll see Part One of the annual query of HIT C-suiters and other head honcho types, “What was the biggest HIT-related news or event in 2011 and why?” Some pretty expectable answers about ICD-10, ACOs, the Stage 2 Meaningful Use delay, mergers/acquisitions, and mobile health – often with some also expectable vendor-centric skew on the take – dominate these execs’ considered replies.

I can’t really say that I disagree much with any of these folks’ points of view, but I’ve been watching the land of HIT from a slightly different perspective of late and I think there may be an even more powerful portent percolating in the periphery of our health tech world. It’s sneaking up on us and it has the potential to change virtually anything and everything we do in healthcare. At least when history looks back, I’m thinking it may just be the true lead story for 2011 … and beyond.

Just as in the Middle East where, via the connectivity they can now muster via the Internets [sic], common folks have inflamed the fires of revolution and toppled longstanding authoritarian rule, I think the growing “militia” that is the so-called “e-patient” (“e” for electronic, empowered, engaged, enlightened, etc.) may just be the as yet unsung “biggest HIT-related” development in 2011. This movement is growing by leaps and bounds, yet most of the HIT world has it only on the periphery of their radars.

You all may be familiar with e-Patient Dave DeBronkhart. Dave is a leader in the budding Society for Participatory Medicine which builds upon the foundations laid by the late Dr. Tom Ferguson and his e-Patients Scholars Working Group using the guiding principle, “When the people are well-informed, they can be trusted to govern themselves.” (This, from the genius Thomas Jefferson, famous figure of a previous toppling of authoritarian rule.)

Founded in 2009, their byline is “Bringing together e-patients and healthcare professionals.” I joined SPM a little earlier this year and though I’ve so far just been listening in, getting a feel for the folks and the forum, I gotta tell you, this now fast-rising rabble has one of the most active and spirited multi-thread e-mail conversations going that I have ever seen. With voices from all over the land of healthcare, be they people/patients or medicos, and all over at least three continents, they are very busily debating just what the direction for consumer-centric healthcare delivery should be and just what people/patients should allow.

Recently, the folks at SPM were going back and forth about the value and/or ulterior motives of corporate involvement with the patient engagement realm (e.g., Merck’s MerckEngage.) Regardless of whether we can always trust the big pharma to always do the right thing or to be driven by high-moral motives, their recognition that healthcare is heading toward a consumer-driven model just adds more fuel to the SPM fires. (Personally, I really enjoyed several great little videos which Merck has on their site of Dr. Marie Savard, an advocate for patient rights and former director for the Center for Women’s Health at the Medical College of Pennsylvania, where she discusses how to start down the e-patient path.)

I lean toward a preference for inclusivity and transparency. I think this whole empowered patient movement will perhaps do more to change the course of our traditionally paternalistic medical world (providers and HIT vendors, included) than any governmentally-driven initiatives or any latest and greatest techno-marvel. Engaged folks have skin in the game and understand that their participation matters. Enlightened consumers have the potential to help drive change, both in how we deliver care and how successful the care outcomes will be. (Isn’t that what ACOs want?)

It will be a little scary for providers (and for HIT vendors) to allow access to our somewhat hidden world. Allowing the general public to see what we write, to have the obligation to explain in real “people-speak”, to invite patients into our so dearly regarded ivory towers, and to elevate consumers onto our pedestals (or to just get rid of those silly pedestals altogether) will greatly challenge some long held credos and egos.

Whether you call them “patients”, “consumers”, or just plain “people”, eventually “they is all us.” We all have a stake in this game. We’re all healthcare consumers at some point. I suggest it is long overdue that we open the doors of the hallowed (and somewhat musty) halls of medicine (and HIT) to let a little sunshine in, some e-patient powered sunshine.

From the trenches (and wishing you all great holidays)…

“There’s a war out there, old friend. A world war. And it’s not about who’s got the most bullets. It’s about who controls the information. What we see and hear, how we work, what we think… it’s all about the information!” – Cosmo, from the movie “Sneakers”

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).