Now Viewing: health care

OpenNotes: Mind the Gap

Jan 4, 2012, 9:00 AM, Posted by Steve Downs

Last week, I contributed to The Health Care Blog about OpenNotes, a Pioneer grantee that is enabling patients to view the notes their doctors write after a medical visit. I wrote that it is a simple idea – but also a dangerous one.

OpenNotes recently completed a pre-survey published in the Annals of Internal Medicine that asked doctors and patients about their expectations of how the idea would play out in real life. What they found is fascinating. Doctors and patients are clearly divided. On a wide range of possible benefits, doctors are more skeptical than patients. But what really jumps out are the responses to questions of whether patients would find the notes more confusing than useful, and whether the notes would make them worry more. The gap is dramatic. In each case, most doctors said “yes” while less than one in six patients agreed.

Why this disconnect between doctors and their patients? Why the gap between what doctors believe their patients can handle, and what patients feel they are ready to see?

The post has generated a nice discussion on the blog, and in the comment responses you’ll find that the results of the survey are reflected in the dialogue. I recently added my own two cents to the conversation, and I’d love to see you post your thoughts, as well.

The survey results have also been covered by USA Today, MSNBC.com, and TIME’s Healthland Blog.

Introducing Innovations for Health: Solutions that Cross Borders

Nov 14, 2011, 8:28 AM, Posted by Deborah Bae

At RWJF, we’re focused on solving the most intractable health and health care challenges in the United States, but we recognize that innovations come from all over the world and that many effective health solutions are emerging with the potential for immediate adaptation, replication and impact. That’s largely because, despite their differences, many countries throughout the world face a surprisingly similar set of health care challenges.

In today’s interconnected world, we have an important opportunity to learn from each other – especially when a new idea has the potential to make a difference in a big way. For example, the New York Times recently released a special section, “Small Fixes,” which focused on low-cost health care innovations to improve global health. The small fixes ranged from simple, self-adjusting eyeglasses for those who don’t have access to optometrists to the sophisticated, Gates-funded “postage stamp” paper to detect liver disease nearly instantaneously—the samples don’t have to be sent to a laboratory to be processed.

The innovation that most caught my interest in this article was one in Mozambique that organized patient groups to take turns picking up their medications, thereby forming strong social bonds, reducing stigma and increasing adherence to antiretroviral drugs. The organized patient groups also reduced the burden on health care workers while increasing patient engagement and self-management of care. Some consider this “small fix” a potential game changer for HIV care.

What’s striking about many of these solutions is that they highlight the universality of health problems faced throughout the world, such as lack of preventive care, provider shortages and rising health care costs. And, while most of the solutions are geared towards solving health problems outside of the United States, with some imagination, I believe many of these fixes could easily improve people’s lives in our country.

It’s this desire to accelerate change by tapping into unconventional thinking around the globe that led the Pioneer team to partner to launch the Innovations for Health: Solutions that Cross Borders competition with Ashoka Changemakers. We’re looking to find solutions to these universal health care issues, and are most interested in those that have potential to:

  • Increase capacity and training for health care workers and providers;
  • Scale low-cost interventions to increase access to medical, preventive, or dental care;
  • Reduce barriers to health information and services;
  • Provide high-quality care in non-traditional settings; and
  • Engage patients directly in their care, particularly those managing chronic illnesses.

We’re thrilled to seek these global health care solutions and hope you’ll check out the competition, learn more about the three $10,000 prizes, and share the link with your network of pioneering thinkers. And why not submit an entry yourself, nominate an organization to compete, or comment on the submissions? We can’t wait to see what ideas you might have.

OpenNotes Hints at Great News to Come

Nov 10, 2011, 11:20 AM

Pioneer grantees Tom Delbanco and Jan Walker, the creative and scientific minds behind OpenNotes, this week published an opinion piece in Modern Healthcare championing the need for patients to easily and securely access their doctor’s notes online and discussing early results from their project. The piece says, “We are learning that patients are overwhelmingly interested in gaining rapid access to their notes and that many doctors appreciate the potential for open records to improve care.” Check out “e-Patient” Dave deBronkart’s take on the Modern Healthcare story.  He calls the early results, “A hint of great news to come, for lovers of participatory medicine.” We couldn’t agree more, and can’t wait for an update coming later this year and final results due out later in 2012.  Stay tuned!

Exploring What We Don't Know at TEDMED 2011

Oct 24, 2011, 3:00 AM

Pioneer is proud to once again sponsor TEDMED, which brings together innovative thinkers and leaders across the fields of medicine, science, business and technology. Traditionally, when people attend TEDMED, they come looking for ideas and inspiration. This year from October 25-28, the Pioneer team will be looking at things from a different perspective: What don't we know about some of the greatest challenges facing health and health care.


TEDMED has identified a tentative set of Twenty Great Challenges of Health and Medicine—deeply rooted problems with multiple, interconnected causes and ripple effects—which they plan to include as part of their 2012 conference. We’ve offered to help TEDMED examine these issues and we believe a good first step is to take a step back and ask: What don’t we know about these problems? What relationships aren’t we seeing?

To do this, we’ll be engaging all 600 conference attendees to get their thoughts on “what don’t we know” about these 20 challenges. Looking closely at what we don't know will help create a big-picture understanding of these challenges—a crucial step to developing truly effective solutions.

We invite you to join us in this exploration. Take a look at TEDMED’s Twenty Great Challenges of Health and Medicine. Then, answer the question, "What don’t we know?" about any of these challenges by tweeting #TEDMEDchallenges, posting a comment below, or e-mailing us at pioneerblog@rwjf.org.

Afterwards, we’ll be compiling what we heard at the conference and what you’ve told us to help TEDMED shape their new Great Challenges Program. Your input is valuable and will directly inform what is done at the TEDMED 2012 conference. We’ll share what we’ve learned in future posts.

How can you share your ideas?

Be sure to check back throughout the week and next for updates from our guests and team members.