Friday, September 21, 2012

Med2.0 (#Med2) -- An Annotated List of Blogs from Med2.0

It has been almost a week since Med2.0.  For those that don’t know, Med2.0 is a conference about using technology in medicine to further and improve patient care and education.  This was my first time attending this conference.  What a wonderful experience!  I had the opportunity to meet some of my physician colleagues whom I had previously not met in real life, but that I knew through Twitter.  In addition, there were others with expertise in other areas from whom I learned so much.
Since the meeting ended, many have written blogs about their experience.  Below is just a smattering of blogs written by a few attendees, reflecting on the awesome experience.

Specific Situations
Hallway Conversations. This blog from @kidney_boy describes the evolution of an educational resource tool, Dynamed, which occurred as a result of a hallway conversation.
Blogging: The “A-HA” Moment about Online Histories.  I wrote this blog halfway through the conference, after reflecting on a panel session on patient blogging and on the importance of asking patients about how they use the internet to search for health information.
Healthcare Needs Social Media.  This blog, by a well-known blogger and pediatrician, Dr. Claire McCarthy, describes the importance of relationships and communication in medicine and how social media aids in improving these.
Thoughts on QR Codes. This blog by @kidney_boy describes how placing QR codes into slide presentations worked well (and not so well) for participants.
Online communities This blog, by @colleen_young, describes how communities through the internet can support individual participants.  Colleen also won an award at the meeting for her work in this arena.  Congrats, Colleen!

At the end
SketchNotes: This blog, by @cassiemc , includes a wonderful pictorial sketch that is worth its weight in gold!
E-Patient  This summary, from Joe Graedon from @Peoplespharmacy summarizes take home points from Day#2 of the conference, highlighting the Society for Participatory Medicine.

General Reflections on the Conference
Student impressionsThis blog by @HodaPharm , describes Hoda’s first-time experience at the conference, with reflections on many different presentations.
Gut Check This blog, by @RyanMadanickMD, a colleague of mine interested in the intersection of medical education and Twitter, summarizes how he learned from people with entirely different interests.
Summary of several individual sessionsThis is a wonderful summary of many sessions attended by @kidney_boy, who blogged this piece for the AJKD at @eJKD .

I am sure that more will blog about their experiences, and hope that this summary provides helpful information for those there, as well as those who were not able to attend.  Please post any comments.  Thanks.
Alex Djuricich

Sunday, September 16, 2012

The "A-HA Moment" about the OH ; Blogging

I am currently enjoying my time at the Med2.0 conference in Boston.  This great group of folks  is coming together to learn and disseminate how to leverage the power of emerging technologies to help improve patient care.  It is simply eye-opening to learn and understand some things coming down the pike which will help health care professionals care for patients in the future.

I attended a session on Blogging by patients which has me thinking.  One of the points that was brought home was that patients with chronic illnesses are blogging about their experiences with having certain health conditions, and that blogging has a powerful effect on how they self-manage their illnesses.  To me, this is VERY powerful.

In another session, a focus was on how many patients are searching for online information about an illness.  I have said this many times, and will say it again here.  The medical community has a duty and an obligation to dispel mis-information which is unfortunately so prevalent on the internet, and to provide simple, truthful, meaningful messages that patients can understand.  What better way to do this than through the use of social media.

One way to know about whether patients are looking online, or posting online through a blog, is to take on online history, or OH.  We should ask patients whether they do this, just like we should take a social history when we first meet them.  This can help us learn about how patients deal with their illness, and how we might be able to best help them.

This is my "A-HA" moment about the OH.  If you are a health care provider, you should consider the importance of the OH: it will be your A-HA moment too, and it will better help you get to know your patient.  Isn't that what the Patient-Doctor Communication is all about, after all?

Sunday, September 2, 2012

Computers in Patient Care

I’d like to start this blog with a comment that I am a strong proponent of using emerging technologies to help improve patient care.  I believe in the power of mobile computers to help us with patient care.  I believe that we should use technology to augment the care we provide, not replace it.  However, I had an interesting hallway conversation with one of my fellow attendings earlier this week, which caused me to reflect on this topic, and ultimately write this.
Electronic medical records are touted to help improve efficiency, to be able to collect information to help us improve the care we provide, as well as other positives that are well-described.  The government is even providing incentives to health care systems and physician practices for “Meaningful Use”.  I have believed in the power of computerized physician order entry, or CPOE, for a while, having had it at one of our training hospitals when I was training in 1994 – 1998.
However, the discussion I had the other day made me really think.  Trainees (and attendings, as well; we are not any different) spend so much of their day on the computer, and this appears to be coming at the expense of face-to-face time with the patients.  This article suggests that direct time with patients is not ideal for residents on call, and that much of the time on call is spent in front of a computer.  12% of the time was spent in direct patient care.  12%!  I am concerned about this, and I bet patients would also have similar concerns.
This article, with a drawing by a child highlighting what they see with regards to doctors and computers, pretty much sums it up: even children are noticing that doctors are “tethered” to the computer.  This has to change! 
I do believe that we can fix this.  It starts with acknowledging this “elephant in the room” (or, more aptly, the “computer in the room”).  I am currently spending a few weeks on the inpatient service at our county hospital, and had the chance to discuss this with our medical students.  We made sure that rounds on patients including going to see the patients and interact at the bedside, not just exclusively sitting around a table discussing the patients.  We discussed motivational interviewing (and demonstrated it) and getting to know patients as people.  We reflected on why all of the students went into medicine, and none said “to type information into a computer.” “Stop and smell the roses” was the take-home message of the day, the roses being, among other things, time with patients.
Please, please make sure that staring into a screen doesn’t replace sitting at a patient’s bedside.  Please make sure to talk to your patients, to look them in the eye, to ask them what they think, and to answer their questions.  It will help the patients, and it will promote the humanism that is at the heart of the patient-physician relationship.  Yes, computers and mobile tablets can help us care for patients, but in my opinion, there is a bond between a patient and a physician which should never be replaced by a computer.  Let’s not break that bond!