Why measure health outcomes? What information comes from outcome data? What action does the information motivate? How do disparities figure in? Why risk adjust?
Following my person-first approach to health, let’s start with people’s circumstances and life flow, put testing into a context of managing the risk of COVID-19. Then let’s tackle what testing even means, what to expect from testing, and then circle back to the person – how do the results impact our circumstances and life flow? Read More
I’m a technology nerd and early adopter while also a profound technology skeptic. My heart sings when communities of people solve problems that matter to them and theirs and then look for technology partners to automate and share their solutions. By community, I mean partnerships of people at the center of care (people, care partners, clinicians) and neighborhoods, counties and states.
Recently, I spent a few days with big data, technology, entrepreneurs, and healthcare under the big top of Health 2.0 in Palo Alto. CA – a relatively low-key festival of mostly entrepreneurs trying to sell big data and apps with the edge of worry about engaging patients in their data and products. I felt at home with my advocacy and community browsing new ideas and new uses for technology Read More
In our 30’s we lived in West Virginia – very rural, back-to-the-land hippies, eight miles up a dirt road. We participated in many communities. Our intentional community of families shared 180 acres of land, helped each other build our houses, raised our kids together, home schooled, with some facsimile of farming – garden, bees, fruit trees, chickens. Another community was the town emergency squad where I volunteered as a paramedic and my wife drove the ambulance. The community of young back-to-the-landers throughout the state was yet another community – playing music, partying, sharing skills, stories and resources. A different community was that of a state-wide network of people teaching Advanced Cardiac Life Support – meeting twice a year to train trainers and then traveling to teach at each other’s courses. Another, was the group of people lobbying for homeschooling in the state capital – conservative Christians alongside hippies. Although it’s the most rural I’ve ever lived, I grew up in Chicago and Detroit, I had the highest sense of community there in rural WV.
Have I written about the Quadruple Aim of healthcare?
1. Improving the patient experience of care,
2. Improving the health of populations,
3. Reducing the per capita cost of health care, and
4. Improving the work life of clinicians and staff.
I live to compete in this quadrathlon. While my focus is the first and fourth – experience of patients and work life of clinicians and staff – the finish line is the second – improving the health of populations. I fear that wild success in experience, cost, and work life might not result in improving the health of populations. Improving the health and well-being of neighborhoods, counties, teens, professional athletes, diabetics, etc. may not be the sum of improving the health of each individual in those populations.
In 2007, I worked for St. Peter’s Recovery Center in Guilderland, NY. My boss, Bob Doherty, had the vision, the foresight, and the stones to engage a whole community to improve the care of persons most disabled by substance abuse. He convened the homeless shelters, religious communities, law enforcement, social services, ambulance companies, emergency rooms, and other community services to take on this intractable puzzle together. Brilliant! Read More