Now Viewing: Patient-centered care

Creating a Knowledge Map with Stanford Medical School

Mar 24, 2014, 1:00 PM, Posted by Mike Painter

Mike Painter, senior program officer Mike Painter, senior program officer

Why should I be in the same room with these people?

That’s one of the many smart questions participants posed at a Stanford Medical School meeting I attended last weekend.  If I had been daydreaming (I’d never do that), I might have thought the question was for me. You see, the participants were a handpicked set of national medical education experts, folks nominally from the status quo medical-education-industrial complex—the very thing we’re trying to change.

You might think that they embodied that dreaded status quo.  I’m happy to report they did not—not even close.  I’m also relieved to tell you that the question (in spite of my paranoia) wasn’t for me. Instead, it was one of many challenges these thoughtful, passionate teachers tossed at each other.

“Why are we in the room?” was a challenge to each other. Why and when should teachers be in the same room with the learners?

When you think about it, that’s actually a central question if you’re attempting to use online education to flip the medical education experience.  It’s also a brave one if you’re a teacher: justify the time you spend with your students.

Read the rest of this post on The Health Care Blog

Pioneering Ideas Podcast: Episode 3

Mar 11, 2014, 8:00 AM, Posted by Pioneer Blog Team

Welcome to the third episode of our podcast, where we explore cutting edge ideas and emerging trends that can transform health and health care. Your host is Lori Melichar, a director at the foundation.

Ideas in this Episode

  • The science of choosing – From TV shows to health plans, Americans have more options than ever before – and we like it. But do we really? What does our relationship with choice mean for our health, and for the health care system as a whole?
  • The radical power of empathy – What happens when a health care provider actually stops and listens to a patient? How does empathy fuel innovation?
  • The next generation of health care innovators – We hear from two students at Princeton University who are studying how to apply social entrepreneurship to address global health challenges.

View Full Post

A Toolkit for Implementing OpenNotes

Mar 10, 2014, 10:00 AM, Posted by Steve Downs

Open Notes_20120530_00726

In writing about OpenNotes last summer, I argued that the practice of sharing clinicians’ notes with patients had moved beyond the question of whether it was a good idea (the landmark study published in Annals of Internal Medicine was pretty clear on that) to questions of how best to implement it.  As more organizations adopt the practice, it’s clear that we’re now in a phase of implementation, and experimentation with different approaches and learning.  Tom Delbanco, MD, one of the project leads, often compares open notes to a drug -- it does have some side effects and some contraindications for some people and some circumstances -- and we all need to understand those nuances.

View Full Post

Dr. Bruce McCarthy of Columbia St. Mary’s on Adopting OpenNotes

Nov 4, 2013, 8:00 AM, Posted by Pioneer Blog Team

Dr. Bruce McCarthy, Columbia St. Mary’s Health System President, Physician Division Dr. Bruce McCarthy, Columbia St. Mary’s Health System President, Physician Division

On Nov. 1, Columbia St. Mary’s Health System in Milwaukee became the first hospital in Wisconsin to implement OpenNotes. Beginning this month, some 1,100 multi-specialty doctors, nurse practitioners, and others who write visit notes will be sharing them with more than 300,000 patients via a secure online portal. Columbia St. Mary’s is part of Ascension Health, the largest nonprofit Catholic health system in the country. This month, it also becomes the first hospital system to share hospital discharge summaries with patients. Bruce McCarthy, MD, President, Physician Division, an internist who oversees the system’s medical group, spearheaded the rollout of OpenNotes here. An innovator who "puts patients first," Dr. McCarthy talked to Pioneer about why it’s time to make the idea of sharing medical notes a routine practice.

View Full Post

Moving Forward with OpenNotes

Aug 14, 2013, 8:00 AM, Posted by Steve Downs

Open Notes_20120530_00476

As Beth Israel Deaconess Medical Center (BIDMC) begins its institutional rollout of OpenNotes, it's becoming clear that we've moved into a new phase of the diffusion of this innovation. I've been in discussions with OpenNotes co-directors Tom Delbanco, MD and Jan Walker, RN, MBA about the idea of opening up physician notes to patients since 2008, when it was a bold, controversial idea that needed to be tested. The landmark study that Tom, Jan and their colleagues conducted over 2011-2012 and published last fall made it quite clear that the idea had merit: overwhelming percentages of patients found it helped them better understand their conditions, feel in more control of their health and even take their medicines more regularly. 99 percent of patients in the study wanted to continue with the practice. As for physicians, their fears went largely unrealized. It simply wasn't a big deal.

Recently we've seen more leading institutions climb on board with the practice of sharing medical notes: the VA is adopting OpenNotes, as is Group Health Cooperative; Geisinger, one of the original study sites, is expanding the practice throughout much of its system; the Cleveland Clinic announced its intention to share visit notes; and you can now read your doctor's notes at the Mayo Clinic. More will undoubtedly follow in the months and years ahead. As we move into the implementation phase at these and other institutions, the questions will shift from whether the idea is good to more practical inquiries around how well it fits certain specialties (like psychiatry) or departments; whether there are patterns in the types of patients (or physicians) that flourish under this approach; and how to manage the cultural changes that OpenNotes implies.

View Full Post