It’s Not About The Box Improving Care at Group Health with People, Process and Technology

September 23, 2011

Shared Decision Making in DC

Filed under: Shared Decision Making — Matt Handley @ 4:59 am

I am at a shared decision making conference in DC  – day 2

Shannon Brownlee, great writer and speaker and author of “Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer” – is leading off the day.  A compelling writer, she started with a story.  A patient with panic attacks that eventually ends up with an angiogram to “just be sure”, despite a very low pretest probability, and after her angiogram looks fine she has a serious complication that leads to cardiac arrest and now serious long term health problems.  A high price to pay for reassurance.  The combination of a passive patient, physicians who did not listen to her whole story, and an over-reliance on technology.

OK – so everyone in the room is hooked

She shared a report that I was not aware of – The California Healthcare Foundations analysis of variation in procedure rates across California.  Important work that extends the idea of the Dartmouth Atlas (which uses Medicare data) to younger populations.  No surprise that there is dramatic variation across the state in most everything.  The researchers have also adjusted for income, race/ethnicity, and CVD risk (using MI and DM as proxies).  There is a great interactive map that you should check out.

This is really an effort to inform three audiences – policy makers/payors, doctors and patients.  We will have to invest in all three groups to work to diminish the variation and have it be driven mostly by clinical circumstances and patient preference

September 19, 2011

New Developments in our Electronic Medical Record

Filed under: Electronic Chart,MyGroupHealth — Matt Handley @ 9:10 am

I am in Madison, Wisconsin, at the Epic User Group Meeting (UGM).  It is always a great event, mostly because it brings together innovative leaders from most of the highest performing group practices in the US.  Today is the Physician Advisory Council (and there are many concurrent council meetings, including nursing and pharmacy, with overlapping topics) and one theme has already emerged throughout the AM talks.  Involving patients more actively.  Great to see!  I am in a session now about having an online questionnaire linked to well visit checks, that makes things easier for both patients (well, their parents) and for clinicians.  Moving work to the time and place it fits best, rather than forcing everything to happen at an in-person visit.

Imagine having pre-visit questionnaires for well visits and for selected visits for chronic illness.  More participation, more convenience.  And then imagine people being able to access their medical record – and their doctor – through their smartphone – oh – we already do that through our iPhone app!

Powered by WordPress