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April Meeting


   PATIENTS 2.0
 INTRODUCING THE
EMPOWERED PATIENT

MARIE ENNIS O’CONNOR
 e-Patients represent the new
Wikipedia     breed of informed health
Definition    consumers, using the Internet to
              gather information about a
              medical condition of particular
              interest to them.

              Encompasses both those who
              seek online guidance for their
              own ailments and the friends and
              family members who go online on
              their behalf.
Tom Ferguson MD: “the
George Washington of patient
empowerment”
E-Patient Dave
                    Diagnosed with terminal kidney cancer
                           Given 24-weeks to live.
David de-Bronkart
                    Joined online cancer patient community.

                    Learned of a clinical trial for a powerful
                        drug that only sometimes works.

                                   It worked!

                         Today he leads the Society for
                            Participatory Medicine.
It is not a failure on the doctor’s
part. There is so much going on
these days. It is impossible for
any one person to keep track of
every new development. But an
army of patients connected
through and fostered by the
internet, may do a better job
collectively. Smart patients can
find things that doctors haven’t
seen.
Katherine
Leon
Patient Advocate for
Women with Heart
Disease, esp.
Spontaneous Coronary
Artery Dissection
(SCAD)



Rare disease



Patient initiated
research Mayo Clinic
Information era converging
           with
      the digital era



     A new model of
    medicine is being
  induced by the digital
 era and the altered way
  in which information
     will be flowing.
New healthcare
 paradigm cannot be
     adequately
understood in terms
of our older medical
constructs, including
 many still taught in
medical school and in
 continuing medical
     education.
The Internet is a place, an
environment, made up of
 people and their myriad
  interactions. It is not
merely a technology but a
       new way of
cooperating, sharing, and
          caring


  Vinton Cerf, American
computer scientist, who is
 recognized as one of "the
 fathers of the Internet."
Pew Research Center’s Internet & American Life Project
Pew Research Center’s Internet & American Life Project
Women are more          Men are more
 likely to search for    likely to search
specific diseases and           for
    other medical          information
problems, reflecting        relating to
their traditional role    sexual health,
   as family health      drugs, alcohol,
      caregivers.         and smoking.
How do e-
patients use
the internet?

                                 The       The
Pew Internet Study   The Well            Chronics
                                Acutes
The Well
                                             Browse for
                                           general health
                                            and wellness    May look up
About 60 - 65 % of e-      They are the
patients are well.                          information.      pertinent
                            lightest and
                                                               medical
                                least
                                                            information
                              frequent     Often serve as
Think about their                                           online before
health only occasionally       users of    managers for       or after a
and sporadically.          online health    other family    doctor’s visit
                             resources.      members’
                                               health              .
                                             concerns.
The Acutes

                        Many use the
About 5 - 6% of e-        Internet
patients facing a new                  Reaching out    Participate in
                         every day.          to            online
medical concern or
challenge.                             professionals      medical
                         Searches       and patients    discussions
                           online        they have      and support
                         resources     found online.   communities.
                        intensively.
The Chronics

                                             Use it to       Most likely to
About 30-35 % of e-                        manage their      develop Web
patients have one or                     illnesses and to    sites for their
                           Moderately                        condition, to
more stable chronic        heavy users   help them keep
                                           up to date on     post content
illnesses, but are not       of online         their        to help others,
currently dealing with a
                              health        conditions.     and to respond
pressing short-term                                              to the
medical challenge.
                            resources.
                                                              questions of
                                           Often active     other patients.
                                         participants in
                                         online support
                                          communities
Satisfaction               Doctor-patient e-mail
Ratings                                                More information
                             Ability to schedule     about drug interactions
Most e-patients appear
                            appointments online
to be quite satisfied
with most aspects of
their experiences using
online health resources.

82% frequently found
                                 BUT - a significant percentage of e-
the information they              patients said that they would have
are looking for online.            liked certain desired services or
                                   features they did not find online
61 % said that online
information improved                                    Access to medical
                           Online diagnostic tools
the way they take care                               records and test results
of themselves.
One e-patient in seven has made an appointment to
                     see a doctor because of information or advice she
                     found online.
More Stats


Responses from Pew   One in seven has asked the doctor to prescribe a
Internet study.      specific medication he learned about online.



                     Patients who have searched for medical information
                     online are considerably more likely to consult
                     doctors than are non-e-patients.


                     Expertise increases with use - more skilled at
                     searching online - more likely to post online content
                     for other patients.
E-Patients’ Use         Helps them feel:
Of Internet


“What I find online      less dependent
helps me to feel
prepared to talk with    less fearful of the unknown
doctors and nurses. I
know the terminology     more capable of asking well-
and the options.”         informed questions
                         more capable of evaluating
                          options
Our first visit to the neurologist, when
my son was diagnosed with autism,
was not as devastating as it could have
been. My husband and I were well
informed and had already figured out
the diagnosis by the time we saw the
doctor. By being better informed, that
first visit was very informative and
constructive because we knew the
background information, weren’t in
denial, and could discuss therapies
and tests in a logical way.
Patients Like Me – a
   chronic disease social
network with over 170,000
users & over 1,000 diseases
 are using crowdsourcing –
asking the public to help in
  their medical research .

 The data generated from
  users has resulted in a
   number of significant
        publications.
   is a social network of
patients connected by their
 experiences with disease.
The patients who produce these sites don't know everything a
         physician might know, but they don't need to.



     They are smart,
     motivated, and
  experienced patients
 with an impressive and
 up-to-date knowledge
   of the best sources,
  centres, treatments,
research, and specialists
   for their condition.


      Particularly knowledgeable on practical coping tips and the
  psychological and social aspects of living with a chronic condition .
We are learning that we are
    qualified through our
 experience, our knowledge,
  and our concern. We now
  see that we are capable of
contributions no professional
can make and that by linking
  our efforts [with those of
      professionals] in a
  coordinated team, we can
       advance the well
         being of all.

Samantha Scolamiero,
founder of the
BRAINTMR mailing list
Amy Tenderich,
Founder of Diabetes Mine


                           We will use tools that
                           answer our questions and
                           solve our problems. We
                           will avoid tools that help
                           us do what you think we
                           should do and we won't
                           use tools that add to the
                           work of caring for
                           ourselves.
Montefiore Medical Center in New York City


Montefiore started a clinic that would see patients 7 days after discharge
to go over medications, post-op activities and care and answer any
questions that the patients had.


                                                    Patients were given a
                                                    wristband with
                                                    Montefiore’s 24/7
                                                    Hotline number and
                                                    told to call with any
                                                    questions
                                                    whatsoever. The
                                                    wristband is a big hit
                                                    with the patients.
60% of GP surgeries have the technology in place to
allow patients online access to their records, yet at
       the moment less than 1% offers this.
 Patients /"consumers" -- will be
E-Patient                    enabled to take active ownership
Wishlist                     of their health.
                            Personal health data will be at
“With free access to
medical                      the centre of our genome-
information, patients
like me can drive our
                             informed, personalised medical
own care for the first       future.
time in history” ~ Amy
Tenderich                   Web-based patient portals.
                            Online consults/e-visits.
                            International standards for
                             mHealth.
But often the most
important revolutions
aren’t announced with
 the blare of trumpets.
They occur quietly, too
   slowly to make the
 news, but fast enough
that if you aren’t alert,
 the revolution is over
before you’re aware it’s
      happening.
C0nnect With Me


         @JBBC
http://journeyingbeyondbreastcancer.com




     http://hcsmmonitor.com

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Patients 2.0 Introducing The Empowered Patient

  • 1. April Meeting PATIENTS 2.0 INTRODUCING THE EMPOWERED PATIENT MARIE ENNIS O’CONNOR
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  • 3.  e-Patients represent the new Wikipedia breed of informed health Definition consumers, using the Internet to gather information about a medical condition of particular interest to them.  Encompasses both those who seek online guidance for their own ailments and the friends and family members who go online on their behalf.
  • 4. Tom Ferguson MD: “the George Washington of patient empowerment”
  • 5. E-Patient Dave Diagnosed with terminal kidney cancer Given 24-weeks to live. David de-Bronkart Joined online cancer patient community. Learned of a clinical trial for a powerful drug that only sometimes works. It worked! Today he leads the Society for Participatory Medicine.
  • 6. It is not a failure on the doctor’s part. There is so much going on these days. It is impossible for any one person to keep track of every new development. But an army of patients connected through and fostered by the internet, may do a better job collectively. Smart patients can find things that doctors haven’t seen.
  • 7. Katherine Leon Patient Advocate for Women with Heart Disease, esp. Spontaneous Coronary Artery Dissection (SCAD) Rare disease Patient initiated research Mayo Clinic
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  • 10. Information era converging with the digital era A new model of medicine is being induced by the digital era and the altered way in which information will be flowing.
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  • 13. New healthcare paradigm cannot be adequately understood in terms of our older medical constructs, including many still taught in medical school and in continuing medical education.
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  • 15. The Internet is a place, an environment, made up of people and their myriad interactions. It is not merely a technology but a new way of cooperating, sharing, and caring Vinton Cerf, American computer scientist, who is recognized as one of "the fathers of the Internet."
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  • 17. Pew Research Center’s Internet & American Life Project
  • 18. Pew Research Center’s Internet & American Life Project
  • 19. Women are more Men are more likely to search for likely to search specific diseases and for other medical information problems, reflecting relating to their traditional role sexual health, as family health drugs, alcohol, caregivers. and smoking.
  • 20. How do e- patients use the internet? The The Pew Internet Study The Well Chronics Acutes
  • 21. The Well Browse for general health and wellness May look up About 60 - 65 % of e- They are the patients are well. information. pertinent lightest and medical least information frequent Often serve as Think about their online before health only occasionally users of managers for or after a and sporadically. online health other family doctor’s visit resources. members’ health . concerns.
  • 22. The Acutes Many use the About 5 - 6% of e- Internet patients facing a new Reaching out Participate in every day. to online medical concern or challenge. professionals medical Searches and patients discussions online they have and support resources found online. communities. intensively.
  • 23. The Chronics Use it to Most likely to About 30-35 % of e- manage their develop Web patients have one or illnesses and to sites for their Moderately condition, to more stable chronic heavy users help them keep up to date on post content illnesses, but are not of online their to help others, currently dealing with a health conditions. and to respond pressing short-term to the medical challenge. resources. questions of Often active other patients. participants in online support communities
  • 24. Satisfaction Doctor-patient e-mail Ratings More information Ability to schedule about drug interactions Most e-patients appear appointments online to be quite satisfied with most aspects of their experiences using online health resources. 82% frequently found BUT - a significant percentage of e- the information they patients said that they would have are looking for online. liked certain desired services or features they did not find online 61 % said that online information improved Access to medical Online diagnostic tools the way they take care records and test results of themselves.
  • 25. One e-patient in seven has made an appointment to see a doctor because of information or advice she found online. More Stats Responses from Pew One in seven has asked the doctor to prescribe a Internet study. specific medication he learned about online. Patients who have searched for medical information online are considerably more likely to consult doctors than are non-e-patients. Expertise increases with use - more skilled at searching online - more likely to post online content for other patients.
  • 26. E-Patients’ Use Helps them feel: Of Internet “What I find online  less dependent helps me to feel prepared to talk with  less fearful of the unknown doctors and nurses. I know the terminology  more capable of asking well- and the options.” informed questions  more capable of evaluating options
  • 27. Our first visit to the neurologist, when my son was diagnosed with autism, was not as devastating as it could have been. My husband and I were well informed and had already figured out the diagnosis by the time we saw the doctor. By being better informed, that first visit was very informative and constructive because we knew the background information, weren’t in denial, and could discuss therapies and tests in a logical way.
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  • 32. Patients Like Me – a chronic disease social network with over 170,000 users & over 1,000 diseases are using crowdsourcing – asking the public to help in their medical research . The data generated from users has resulted in a number of significant publications. is a social network of patients connected by their experiences with disease.
  • 33. The patients who produce these sites don't know everything a physician might know, but they don't need to. They are smart, motivated, and experienced patients with an impressive and up-to-date knowledge of the best sources, centres, treatments, research, and specialists for their condition. Particularly knowledgeable on practical coping tips and the psychological and social aspects of living with a chronic condition .
  • 34. We are learning that we are qualified through our experience, our knowledge, and our concern. We now see that we are capable of contributions no professional can make and that by linking our efforts [with those of professionals] in a coordinated team, we can advance the well being of all. Samantha Scolamiero, founder of the BRAINTMR mailing list
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  • 37. Amy Tenderich, Founder of Diabetes Mine We will use tools that answer our questions and solve our problems. We will avoid tools that help us do what you think we should do and we won't use tools that add to the work of caring for ourselves.
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  • 42. Montefiore Medical Center in New York City Montefiore started a clinic that would see patients 7 days after discharge to go over medications, post-op activities and care and answer any questions that the patients had. Patients were given a wristband with Montefiore’s 24/7 Hotline number and told to call with any questions whatsoever. The wristband is a big hit with the patients.
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  • 45. 60% of GP surgeries have the technology in place to allow patients online access to their records, yet at the moment less than 1% offers this.
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  • 47.  Patients /"consumers" -- will be E-Patient enabled to take active ownership Wishlist of their health.  Personal health data will be at “With free access to medical the centre of our genome- information, patients like me can drive our informed, personalised medical own care for the first future. time in history” ~ Amy Tenderich  Web-based patient portals.  Online consults/e-visits.  International standards for mHealth.
  • 48. But often the most important revolutions aren’t announced with the blare of trumpets. They occur quietly, too slowly to make the news, but fast enough that if you aren’t alert, the revolution is over before you’re aware it’s happening.
  • 49. C0nnect With Me @JBBC http://journeyingbeyondbreastcancer.com http://hcsmmonitor.com

Editor's Notes

  1. Vinton Gray "Vint" Cerf is an
  2. relatively minor medicalcondition to more serious conditionfacing a challenging new development for apreviously diagnosed conditionexperiencing a troublesome side effect or other treatment complications