Josh and I are gearing up for tomorrow’s first PCHIT Advisory Group meeting, at the Center for Information Therapy headquarters in Bethesda, Maryland. Why an advisory group? We would like to add additional perspectives and knowledge from other communities/projects to this work, among other things. We plan to post materials from the meeting here, so everyone can be informed about the progress we are making.

Speaking of progress, one of the things I am doing is integrating practices from the Toyota Management System into this meeting as well as the entire project. For tomorrow, this means presenting the work as a PDCA cycle, and using A3 documents, in paper form, to go over things, as opposed to a slide deck.

We’re excited to host this distinguished group and think things will go well, which means we’ll learn how we can improve things for the next communities we visit.

I will be doing a considerable amount of my blogging about information therapy (Ix) at the now-live Patient Centered Health Information Technology (PCHIT) blog. The Center for Information Therapy’s (IxCenter’s) new PCHIT Initiative will have an active learning community of clinicians hosted by me and Ted Eytan, MD, the IxCenter’s Senior Visiting Fellow, who is currently on sabbatical from Group Health Cooperative in Seattle, where he serves as Medical Director for Health Informatics & Web Services.

–Josh

Things are busy around here. We are hosting our first Advisory Group meeting this week, and then heading to community #2, Boston, Massachusetts.

While there, we will be observing practices at Harvard Vanguard Medical Associates, who operate MyHealth Online, Partners Healthcare, who operate Patient Gateway, and East Boston Neighborhood Health Center.

How do we set these up and what do we do? First, we establish contact with the appropriate leader in the organization who is willing to let Josh Seidman and/or myself observe the process of care. In the case of this community, we’ve really been helped by Joe Kimura, MD from Harvard Vanguard/Atrius Health, Jonathan Wald, MD from Partners Healthcare, and Frances Kuebler, MD, from East Boston Neighborhood Health Center. Even with an introduction from a leader in the organization, there is still some relationship building that needs to happen with busy clinicians, and I will typically do that on the spot. In the case of Harvard Vanguard, I have already met the clinicians who are allowing me to watch the process of care.

Speaking of naming names, Neil Calman, MD asked me a provocative question, about the naming of individuals I shadow (not the patients, their experience is always protected). I have always assumed in a public space like this that not everyone wants to be explicitly named. On the other hand, I haven’t minded being named in another person’s blog as long as the reference is accurate.

So, with this trip, I am going to ask the question about attribution to those who I work with, as a little informal poll.

To the readers of this blog - what do you think - is it useful to the story to hear specifics about the practitioners we work with? Thanks for the input.

PCHIT links for October 26th through October 27th:

• Major U.S. payers support Patient-Centered Primary Care Collaborative - Picking up steam - a way to support these activities in every day practice
• Google says it’s working to solve health record dilemma | CNET News.com - The title says it all
• The Partnership for Healthcare Excellence - A new Web site to empower consumers in seeking the best care in the Massachusetts area.

I was treated to the news that Dr. Neil Calman, President of CEO of the Institute for Family Health has launched his own blog, at http://neilcalman.blogspot.com/. Of course I’m excited by this as I got to meet Neil and his care system very recently and will look forward to being updated about things as they happen with Neil and IFH. When I see Neil, instead of asking, “what’s happening, Neil?” maybe I’ll be asking, “how’s that thing happening, Neil?”

I have noticed in some of my own professional interactions that the conversations start more deeply, more quickly, when I am having them with someone who has been following a blog of mine. I have to remember what I write so I don’t tell the same story. My antidote for this is to appeal to others to have their own blogs, so they can experience the same embarrassment.

I think this is a great way to stay connected to other leaders, and hopefully we’ll have Neil write a few guest posts about the work IFH is doing to support patient centered health information technology.

PCHIT Advisors and Partners Biographies

The PCHIT Initiative is grateful to a terrific group of advisors and partners that is helping to guide the project.  This Thursday we will be holding the first PCHIT advisory group meeting to seek guidance and get recommendations for how to evolve the project as effectively as possible.Biographies for the advisory group and the key partners and staff listed below are in the linked file.

Advisory Group

• Michael S. Barr, MD, MBA, FACP, American College of Physicians
• Patricia Flatley Brennan, RN, PhD, University of Wisconsin-Madison
• Susannah Fox, Pew Internet & American Life Project
• Deven McGraw, National Partnership for Women & Families
• Charles Milligan, Jr., Center for Health Program Development & Management, University of Maryland, Baltimore County

Project Staff and Partners

• Veenu Aulakh, MPH, California HealthCare Foundation
• Rachel Block, United Hospital Fund
• Ted Eytan, MD MS MPH, Group Health Cooperative (also serving as Senior Visiting Fellow, Center for Information Therapy)
• Joshua Seidman, PhD, Center for Information Therapy

Patient-Physician E-mail: An Opportunity to Transform Pediatric Health Care Delivery — Rosen and Kwoh 120 (4): 701 — Pediatrics

Josh Seidman alerted me to this recently published study of the use of patient-physician e-mail in a smaller pediatric rheumatology practice. The study shows that the state of the art for many practices like this is still unencrypted e-mail as was used in this case. At the same time, the authors did a nice job quantifying time spent communicating this way as well as the impact on patient satisfaction. Of significance, they found that e-mail responses took physicians 57% less time on average to complete.

The article adds to the body of knowledge that this is a good thing to do. Of course, I might ask if in the future we should quantify the time savings to patients in addition to / instead of to physicians. The other curiosity I had after reading the article was the statement repeated multiple times throughout that “pediatricians are leaders when it comes to using patient-physician e-mail.” I didn’t see any data to support this. Maybe this is a bit of cheerleading to enhance adoption in the pediatrician community? At this point in our work, I can imagine that it is important to describe differences in various specialties’ use of patient centered health information technology, but not sure of the importance of singling out any specific specialty as the “leader.” Open to any comments to the contrary….

A major portion of the work of this initiative is observations of patients receiving care in different health systems. The blog will tell stories in an informal way and allow others to interact with the health systems being featured.

The purpose of the blog is to showcase innovative health care organizations as they transform themselves to become more patient centric through the use of technology.

What are the benefits?

• It will increase interactivity in the field of patient empowerment
• It will expose innovative organizations to the world of Web2.0 technologies and their use in promoting image
• It will assist policy makers and leaders in understanding care provision at the level of the patient

How will it be done - what are the ground rules?

(more…)

Toward the end of the last century, the federal government focused the country’s public priorities around a series of Healthy People 2000 Objectives. In the late 1990s, HHS (the U.S. Department of Health & Human Services) advanced a more ambitious set of goals, Healthy People 2010. They “challenge individuals, communities and professsionals…to take specific steps to ensure that good health, as well as long life, are enjoyed by all.”

HHS has begun planning for the next generation of objectives, Healthy People 2020, and has encouraged the development of an informaton therapy (Ix) objective to stimulate more effective communication about health issues. The IxCenter (http://www.ixcenter.org/) has been working for a year on developing technical definitions of what consitutes Ix to feed into these kinds of public health endeavors as well as private sector efforts aimed at stimulating market rewards for Ix.

We will soon be tailoring our existing Ix definitional work to the Healthy People rubric, and working with HHS to try to embed Ix into Healthy People 2020.

You can now find a Summary of 6th Annual Ix Conference at the IxCenter Web site. PowerPoint presentations and videos will be posted there soon.