“Deep Support” in Patient CareReengineering Healthcare to Support Patient-Centered

Communication and Continuity of Care

Bradford W. Hesse, PhDChief, Health Communication & Informatics Research

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“Greatest innovators (e.g., Henry Ford) ... discovered the possibility

of a new kind of convergence between consumers’ desires, technological capabilities, and organizational innovations.”

The Support Economy

SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking.

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“Greatest innovators (e.g., Henry Ford) ... discovered the possibility

of a new kind of convergence between consumers’ desires, technological capabilities, and organizational innovations.”

The Support Economy

SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking.

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“Deep support provides ongoing relationship based on advocacy, mutual respect, trust, and the acute

alignment of interests.”

The Support Economy

SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking.

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“Deep support provides ongoing relationship based on advocacy, mutual respect, trust, and the acute

alignment of interests.”

The Support Economy

SOURCE: Zuboff, Shoshana, & Maxmin, James. (2002). The support economy : why corporations are failing individuals and the next episode of capitalism. New York: Viking.

“The new digital technologies are essential to the successful

consolidation of this new ... logic.”

Example

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Source: Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K,Yood JG, Taplin SH (2005). Cervical cancer in women with comprehensive health care access: Attributable factors in the screening process. JNCI, 97(9), 675-683.

The Support Economy

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Source: Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K,Yood JG, Taplin SH (2005). Cervical cancer in women with comprehensive health care access: Attributable factors in the screening process. JNCI, 97(9), 675-683.

The Support EconomyWHY IMPORTANT?

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Communica)on  Errors  at  Root

Source: Mazor KM, Roblin DW, Greene SM, et al. Toward patient-centered cancer care: patient perceptions of problematic events, impact, and response. J Clin Oncol. May 20 2012;30(15):1784-1790.

• Interviews with 416 cancer patients across 3 clinical sites (Mazor, et al, 2012)

• Asked about events where something “went wrong,” the event could have been prevented, and the event could have caused significant harm.

Results*• 28% described problem with

medical care

• 47% described a communication problem

• 24% described problem with both communication and medical care

* Of those reporting error

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Accoun)ng  for  Two  Types  of  Error

Errors of Commission: Doing something wrong (root cause of detectable errors)

Errors of Omission: Failing to do something right (e.g., Pap failure - leads to more insidious consequences)

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Just a 1% reduction would save $400 billion

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Eliminating Errors

SOURCE: Hesse, B. W., & Shneiderman, B. (2007). eHealth research from the user's perspective. Am J Prev Med, 32(5 Suppl), S97-103.

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Source: Hesse BW. Public Health Informatics. In: Gibbons MC, editor. eHealth Solutions for Healthcare Disparities. New York, NY: Springer; 2007. p. 109-129.

Engaging Patients, Managing Populations

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HITECH Act

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Meaningful Use as Building Blocks

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Consumers: HP 2020 Goals

http://www.healthypeople.gov/2020

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Consumers: Surveillance, Internet

Source: Hesse, B.W., Gaysinsky, A., Vieux, S., Ottenbacher, A., Moser, R.P., Blake, K.D, Chou, W.S., Beckjord, E. (in press). Meeting the Healthy People 2020 Goals: Using the Health Information National Trends Survey to Monitor Progress on Health Communication Objectives, Journal of Health Communication.

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Consumers: Surveillance, Med Use

Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.

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Consumers: Surveillance, Med Use

Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.

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Consumers: Surveillance, Med Use

Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.

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Consumers: Surveillance, Med Use

Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860.

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Technology: Adoption

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Technology: Adoption

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Technology: Development

Wendy Nilsen

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Organizations: Biggest Gap

Computational Technology for Effective Health Care advocates re-balancing the portfolio of investments in health care IT to place a greater emphasis on providing cognitive support for health care providers, patients, and family caregivers ...

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Digital Future

“Computing for Teams”

Organizations: Human System Integration

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Digital Future

“Computing for Teams”

Organizations: Human System Integration

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Organizations: Improving Process

Stephen Taplin Neeraj Arora

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Organizations: Process Support

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Target: Empowered Partners

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Deep Support

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Thank you!

Slideshare.nethttp://www.slideshare.net/BradfordHesse

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